DR. PATRICK MICHAEL SULLIVAN NEVILLE (NPI# 1588959548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588959548 |
| Entity Type | Individual |
| Full Name | DR. PATRICK MICHAEL SULLIVAN NEVILLE |
| Credential | M.D. |
| Practice Address |
4600 Memorial Dr Ste 120 Belleville IL 62226-5359 |
| Mailing Address |
4600 Memorial Dr Ste 120 Credentialing Department Belleville IL 62226-5359 |
| Practice Telephone | 6182574644 |
| Mailing Telephone | 6182574644 |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2015-06-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
57.017278 | OH | Allopathic & Osteopathic Physicians |
| Street Address |
4600 MEMORIAL DR STE 120 |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-5359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093224768 | Molly Claire Wade | Physician Assistant | 4600 Memorial Dr Ste 120, Belleville, IL 62226 | 2017-09-26 |
| 1821530304 | Anthony David Tarr | Registered Nurse | 4600 Memorial Dr Ste 120, Belleville, IL 62226-5359 | 2016-11-15 |
| 1578828612 | Melanie Renee Nukala | Surgery | 4600 Memorial Dr Ste 120, Belleville, IL 62226-5359 | 2012-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033510284 | Msa Alliance, LLC Dba-southern Illinois Vascular and Vein Surgery | Surgery | 4600 Memorial Dr, Suite120, Belleville, IL 62226-5368 | 2014-09-08 |
| 1548680267 | Msa Alliance, LLC | Surgery | 4600 Memorial Dr, Suite W2, Belleville, IL 62226-5368 | 2014-04-21 |
| 1578828612 | Melanie Renee Nukala | Surgery | 4600 Memorial Dr Ste 120, Belleville, IL 62226-5359 | 2012-07-04 |
| 1063728038 | Msa Alliance, LLC | Surgery | 4600 Memorial Dr, Ste 240, Belleville, IL 62226-5368 | 2010-08-27 |
| 1407944192 | Southern Illinois Vascular Surgery, PC | Surgery | 311 W Lincoln St, Suite 200, Belleville, IL 62220-1902 | 2006-10-10 |
| 1033154190 | Kosit Prieb | Surgery | 311 W Lincoln St, Suite 200, Belleville, IL 62220-1902 | 2006-06-20 |
| 1194768432 | Hans Hassan Moosa | Surgery | 4600 Memorial Dr, Ste. 240, Belleville, IL 62226-5368 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396267324 | Congress Vascular Center LLC | Surgery | 41 W Congress Pkwy Fl 1, Chicago, IL 60605-1531 | 2017-07-11 |
| 1043731300 | Elmwood Park Vascular Center LLC | Surgery | 7230 W North Ave Ste 108, Elmwood Park, IL 60707-4261 | 2017-06-27 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1992126668 | Vascular Specialists LLC | Surgery | 20060 Governors Dr Ste 102, Olympia Fields, IL 60461-1099 | 2013-12-26 |
| 1235454968 | Margaret Claire Rigamer | Surgery | 1901 W Harrison St Dept Of, Chicago, IL 60612-3714 | 2010-04-06 |
| 1215251541 | John V. White, Md, LLC | Surgery | 8816 W Dempster St, Niles, IL 60714-5109 | 2010-03-15 |
| 1710212733 | Vascular Surgery and Interpretation S.c. | Surgery | 3330 W 177th St Ste 2c1, Hazel Crest, IL 60429-2184 | 2009-10-08 |
| 1538391792 | Usa Vein Clinics of Chicago LLC | Surgery | 4141 Dundee Rd, Northbrook, IL 60062-2129 | 2009-08-20 |
| 1306010731 | Tanq, Inc. | Surgery | 18510 S Marilynn Ct, Mokena, IL 60448-9517 | 2008-04-16 |
| 1063606432 | Mohammed Al-zoubaidi | Surgery | 2 Good Samaritan Way Ste 220, Mount Vernon, IL 62864-2476 | 2007-08-29 |
| Find all providers with the same taxonomy | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.