Most Relevant Information
Provider Data
| NPI Number: | 1003511486 |
| Provider Name: | DANA M SULLIVAN DNP, FNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 209.028043 |
Most Important Dates
| Enumeration Date: | 04/04/2023 |
| Last Updated: | 09/05/2023 |
Provider Practice Location
900 N KINGSBURY ST STE 130N
CHICAGO
IL
606107457
Practice Location Phone/Fax
| Phone: | 3127751100 |
| Fax: |
Provider Mailing Location
12712 BLUEBELL AVE
HUNTLEY
IL
601426367
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |