Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JERRY L. SULLIVAN JR., ATC
Active Sole ProprietorMR. JERRY L. SULLIVAN JR., ATC is a Athletic Trainer healthcare provider located in SPRINGFIELD, Illinois. NPI 1306909551 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · SPRINGFIELD, IL
Registration Details
- NPI Number
- 1306909551
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 19, 2006 (19.625171458518 yrs)
- Last Updated
- Jul 8, 2007
- Sole Proprietor
- Yes
Practice Information
- Address
-
3631 S. SIXTH STREETSPRINGFIELD, IL, 62703Browse IL providers · Browse ZIP 62703
- Phone
- 2173414955
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in SPRINGFIELD, IL
| Name | Credential | NPI |
|---|---|---|
| MR. KYLE MICHAEL JOHNSON | ATC | 1528070539 |
| MISS CASSIE A. DORSEY | ATC | 1588781439 |
| KERI ANNE SNYDER | MS, ATC, PES | 1770869943 |
| MR. TENSHI FURUMI | MA, ATC | 1447519111 |
| MR. PETER MARTIN STOLL | LAT, EMT-B | 1205181906 |
| JENNIFER LEE SHURTZ | MS, ATC | 1609121466 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.