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:
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Health care specialties

SpecialtyCodeLicense #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 last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447539655 NPPES
Wisconsin MEDICAID 100040719
Wisconsin Other 032.0109679

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