Sullivan, Paul Mark
Sullivan, Paul Mark is an individual health care provider with primary practice located at 10751 W 143Rd St , Orland Park IL 60462-1900. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Sullivan, Paul Mark can be contacted via phone (708) 460-8688.Contact Information
Primary practice address
10751 W 143Rd St
Orland Park IL 60462-1900
Phone: (708) 460-8688
Fax: (708) 460-9272
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | CH7806 | Florida |
| Chiropractic Providers / Chiropractor | 111N00000X | Illinois |
Profile Details
| NPI number | 1023000700 |
|---|---|
| LBN Legal business name | Sullivan, Paul Mark |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 18th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023000700 | NPPES |
| Illinois | Other | 2645935 | AETNA HMO |
| Illinois | Other | 7199255 | AETNA HMO |
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