Sullivan, Theresa E
Sullivan, Theresa E is an individual health care provider with primary practice located at 13250 Washington Ave , Mount Pleasant WI 53177-1516. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Sullivan, Theresa E can be contacted via phone (262) 799-8700.Contact Information
Primary practice address
13250 Washington Ave
Mount Pleasant WI 53177-1516
Phone: (262) 799-8700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 125060039 | Illinois |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 62926 | Wisconsin |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 62926 | Wisconsin |
Profile Details
| NPI number | 1447539655 |
|---|---|
| LBN Legal business name | Sullivan, Theresa E |
| Credentials | D.O. , M.P.H |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 5th, 2011 |
| Last updated | Oct 16th, 2023 - about 3 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 | 1447539655 | NPPES |
| Wisconsin | MEDICAID | 100040719 | |
| Wisconsin | Other | 032.0109679 |
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