Therese Eileen Sullivan, PA-C is a medicare enrolled "Physician Assistant" in Lemont, Illinois. Her current practice location is
47 Brookside Dr, Lemont, Illinois. You can reach out to her office (for appointments etc.) via phone at
(630) 257-8428.
Therese Eileen Sullivan is licensed to practice in Illinois (license number 085003070) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1629265251.
Provider's Profile
Full Name | Therese Eileen Sullivan |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 47 Brookside Dr, Lemont, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1629265251
- Provider Enumeration Date: 09/27/2007
- Last Update Date: 09/27/2007
Medicare PECOS Information:
- PECOS PAC ID: 1456303569
- Enrollment ID: I20110614000780
Medical Identifiers
Medical identifiers for Therese Eileen Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1629265251 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | 085003070 (Illinois) | 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. Therese Eileen Sullivan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Therese Eileen Sullivan, PA-C 47 Brookside Dr, Lemont, IL 60439-7709 Ph: (630) 257-8428 | Therese Eileen Sullivan, PA-C 47 Brookside Dr, Lemont, IL 60439-7709 Ph: (630) 257-8428 |
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