NPI 1033403282

Sullivan Medical Square, INC

Organisation General Practice Physician Chicago, IL

Practice location

Address: 15 S Kedzie Ave, Chicago, IL 60612-2705
Phone: (773) 638-2651

Authorised official

Name: Brian Murray
Title: Owner
Phone: (773) 638-2651

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 03612661 (IL)

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Registry record

NPI: 1033403282
Entity type: Organization
NPI issued: 6 Jun 2011
Record last updated: 14 Aug 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.