LISA SULLIVAN, MD S.C. (NPI# 1790949980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790949980 |
| Entity Type | Organization |
| Organization Name | LISA SULLIVAN, MD S.C. |
| Other Organization Name | PANACEA ALLERGY, ASTHMA & IMMUNOLOGY |
| Practice Address |
737 Saint Johns Ave Highland Park IL 60035-4650 |
| Mailing Address |
770 Rice St Highland Park IL 60035-5014 |
| Practice Telephone | 8478058088 |
| Practice Fax Number | 8478058088 |
| Mailing Telephone | 8478058088 |
| Mailing Fax Number | 8478058844 |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2020-04-28 |
| Authorized Official Name | LISA MARIE SULLIVAN (OWNER) |
| Authorized Official Telephone | 8478058088 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
036107599 | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| PANACEA Allergy, Asthma & Immunology | Doing Business As Name - Organization |
| Street Address |
737 SAINT JOHNS AVE |
| City | HIGHLAND PARK |
| State | IL |
| Zip Code | 60035-4650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386650273 | Lisa Marie Sullivan | Allergy & Immunology | 737 Saint Johns Ave, Highland Park, IL 60035-4650 | 2006-07-31 |
| 1154931350 | Brittany Elizabeth Ells | Physician Assistant | 737 Saint Johns Ave, Highland Park, IL 60035-4650 | 2020-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140006 | Julian Jay Freeman | Internal Medicine | 1954 1st St., Suite 263, Highland Park, IL 60035 | 2019-05-22 |
| 1851838858 | Melissa Block | Lactation Consultant, Non-RN | 303 Sheridan Road, Highland Park, IL 60035 | 2017-01-27 |
| 1750838280 | Megan Hyatt | Physical Therapist | Central Parkway, Store #210, Highland Park, IL 60035 | 2016-09-01 |
| 1962865907 | Timothy C Dennis | Counselor | 1724 1st St., Nicasa, Highland Park, IL 60035 | 2016-03-29 |
| 1821458027 | Sarah Marie Pinger | Counselor | 1724 1st Street, Highland Park, IL 60035 | 2016-03-01 |
| 1508262775 | Jennifer Francis Gilbert | Social Worker | 1067 Centerfield Court, Highland Park, IL 60035 | 2014-11-14 |
| 1588070148 | Hpoms | Clinic/Center | 1893 Sheridan Rd Suite 311, Highland Park, IL 60035 | 2014-07-03 |
| 1477974152 | Mtca Psychological Services of Illinois P.C. | Psychologist | 1651 Richfield Avenue, Highland Park, IL 60035 | 2013-12-23 |
| 1760819510 | Linda Beth Greco | Social Worker | 274 Linden Park Place, Highland Park, IL 60035 | 2013-10-10 |
| 1770821373 | Eve Cooper Agin | Counselor | 1866 Sheridan Road, Suite 203, Highland Park, IL 60035 | 2013-01-17 |
| Find all providers in zip 60035 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619304342 | Glueck Md, LLC | Clinic/Center | 600 Central Ave, Suite 315, Highland Park, IL 60035-3211 | 2013-09-26 |
| 1902122724 | Eva Bamberger Stahl,mdpa | Clinic/Center | 31 River Rd, Highland Park, NJ 08904-1731 | 2010-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295351062 | Sara M Gotheridge Md LLC | Clinic/Center | 630 Davis St Ste 301, Evanston, IL 60201-4480 | 2020-06-17 |
| 1407484645 | Macumber Medical Ltd | Clinic/Center | 3114 W Irving Park Rd Ste 1w, Chicago, IL 60618-3435 | 2020-04-01 |
| 1477181782 | Embassy Studios North | Clinic/Center | 6455 N Cicero Ave, Lincolnwood, IL 60712-3407 | 2020-03-31 |
| 1689226318 | Midway Spine and Joint Pain Physicians | Clinic/Center | 5720 S Pulaski Rd, Chicago, IL 60629-4435 | 2019-07-12 |
| 1215598891 | Vero Clinics | Clinic/Center | 1192 E Pershing Rd, Decatur, IL 62526-4753 | 2019-06-25 |
| 1497215933 | Activate Healthcare | Clinic/Center | 2010 N Damen Ave Unit F, Chicago, IL 60647-3286 | 2019-03-21 |
| 1033699467 | Healthpointe Medical Center Sc | Clinic/Center | 530 Fullerton Rd Ste B, Swansea, IL 62226-2970 | 2018-08-15 |
| 1740794882 | Highland Park Cvs, L.L.C. | Clinic/Center | 72 Airport Plz, Bethalto, IL 62010-1774 | 2017-11-28 |
| 1447764014 | Dr Courtney Drendel Inc | Clinic/Center | 515 Hamilton St # 100, Geneva, IL 60134-2138 | 2017-11-19 |
| 1699206599 | David M Conner M.d. | Clinic/Center | 9 Executive Woods Ct Ste 2, Swansea, IL 62226-2016 | 2017-03-22 |
| Find all providers with the same taxonomy | ||||
| City | HIGHLAND PARK |
| Zip Code | 60035 |
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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.