| John F Sullivan Dds & Patrick M Gorman Dds Ltd | |
|
615 East 162nd Street South Holland IL 60473-2389 | |
| (708) 331-1900 | |
| (708) 331-1248 |
| Full Name | John F Sullivan Dds & Patrick M Gorman Dds Ltd |
|---|---|
| Speciality | Dentist |
| Location | 615 East 162nd Street, South Holland, Illinois |
| Authorized Official Name and Position | Patrick Michael Gorman (CO OWNER PARTNER) |
| Authorized Official Contact | 7083311900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John F Sullivan Dds & Patrick M Gorman Dds Ltd 615 East 162nd Street South Holland IL 60473-2389 Ph: (708) 331-1900 | John F Sullivan Dds & Patrick M Gorman Dds Ltd 615 East 162nd Street South Holland IL 60473-2389 Ph: (708) 331-1900 |
| NPI Number | 1255544912 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255544912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019A12318 (Illinois) | Primary |
| 122300000X | Dentist | (Illinois) | Secondary |
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