Stacey Lynn Sullivan, CMA - Physician Assistant in Chicago, IL

Stacey Lynn Sullivan, CMA is a Physician Assistant - Medical based in Chicago, Illinois. Stacey Lynn Sullivan is licensed to practice in * (Not Available) (license number ) and her current practice location is 1725 W Harrison St, Suite 408, Chicago, Illinois. She can be reached at her office (for appointments etc.) via phone at (312) 997-2229.

NPI number for Stacey Lynn Sullivan is 1891866646 and her current mailing address is 1646 S 57th Ct, Cicero, Illinois. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1891866646.

Contact Information

Stacey Lynn Sullivan, CMA
1725 W Harrison St, Suite 408,
Chicago, IL 60612
(312) 997-2229
(312) 666-4163

Map and Direction




Provider's Profile

Full NameStacey Lynn Sullivan
GenderFemale
SpecialityPhysician Assistant - Medical
Location1725 W Harrison St, Chicago, Illinois
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1891866646
  • Provider Enumeration Date: 11/13/2006
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Stacey Lynn Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1891866646NPI-NPPES
1616020OtherILBC/BS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AM0700XPhysician Assistant - Medical (* (Not Available))Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stacey Lynn Sullivan is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Stacey Lynn Sullivan, CMA
1646 S 57th Ct,
Cicero, IL 60804

Ph: (773) 936-8105
Stacey Lynn Sullivan, CMA
1725 W Harrison St, Suite 408,
Chicago, IL 60612

Ph: (312) 997-2229

Reviews and Comments


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