Michael J Sullivan (NPI# 1881097236, PAC ID# 9335361930) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
Nation Provider ID (NPI) | 1881097236 |
PAC ID by PECOS | 9335361930 |
Professional Enrollment ID | I20141115000347 |
Full Name | Michael J Sullivan |
Organization Legal Name | FAIRVIEW HEIGHTS MEDICAL GROUP SC |
Address |
155 E Bethalto Dr Bethalto IL 62010-1801 |
Phone Number | 6186323343 |
Gender | M |
Graduation Year | 2014 |
Primary Specialty | PHYSICIAN ASSISTANT |
Group Practice PAC ID | 6800784083 |
Number of Group Practice Members | 199 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
140185 | MEMORIAL HOSPITAL |
140307 | METRO-EAST SERVICES INC |
Address | Phone | Organization |
---|---|---|
155 E Bethalto Dr, Bethalto, IL 62010-1801 | 6186323343 | FAIRVIEW HEIGHTS MEDICAL GROUP SC |
Organization Legal Name | FAIRVIEW HEIGHTS MEDICAL GROUP SC |
Physicians | 197 |
Name | Specialty | Organization | Address |
---|---|---|---|
Jessica Lynn Riney | Nurse Practitioner | Fairview Heights Medical Group Sc | 2 Memorial Dr, Suite 220, Alton, IL 62002-6723 |
Juletta Avagyan | Hospitalist | Fairview Heights Medical Group Sc | 1 Memorial Dr, Alton, IL 62002-6722 |
Stanley Gooding | Nurse Practitioner | Fairview Heights Medical Group Sc | 5520 Godfrey Rd, B, Godfrey, IL 62035-2508 |
Christine A Testa | Nurse Practitioner | Fairview Heights Medical Group Sc | 6810 State Route 162 102, Maryville, IL 62062-8560 |
Supraja Reddy Reddy | Endocrinology | Fairview Heights Medical Group Sc | 11155 Dunn Rd 109, St Louis, MO 63136-6150 |
Kristen N Massey | Nurse Practitioner | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
Ann M Davis | Nurse Practitioner | Fairview Heights Medical Group Sc | 1225 Graham Rd, Suite 2310, Florissant, MO 63031-8023 |
Guy W Aton | Internal Medicine | Fairview Heights Medical Group Sc | 3550 College Ave, B, Alton, IL 62002-5008 |
Mattison Perez | Physician Assistant | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
Lance L Lane | Physician Assistant | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
Street Address |
155 E BETHALTO DR |
City | BETHALTO |
State | IL |
Zip | 62010-1801 |
Name | Specialty | Organization | Address |
---|---|---|---|
Kristen N Massey | Nurse Practitioner | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
Mattison Perez | Physician Assistant | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
Lance L Lane | Physician Assistant | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
Charles L Lehmann | Orthopedic Surgery | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
Bushra Shaukat | Hospitalist | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
Adriena C Beatty | Obstetrics/gynecology | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
Gregory S Churchill | Physician Assistant | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
Kashif S Bhutto | Pulmonary Disease | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
Victoria Oluwaseun Deboise | Hospitalist | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
Molly Clare Wade | Physician Assistant | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
Find all physicians in the same address |
Name | Specialty | Organization | Address |
---|---|---|---|
Matthew E Labertew | Chiropractic | 416 W Bethalto Dr, Bethalto, IL 62010-1700 | |
Rajnikant K Patel | Internal Medicine | 404 W Bethalto Dr, Bethalto, IL 62010-1700 | |
Kory J Stassi | Chiropractic | 112 W Bethalto Blvd, Bethalto, IL 62010-1703 | |
Matthew E Duban | Emergency Medicine | Uptown Emergency Physicians, LLP | 159 E Mcarthur Dr, Bethalto, IL 62010-1777 |
Stephany Renee Luchtefeld | Nurse Practitioner | Uptown Emergency Physicians, LLP | 159 E Mcarthur Dr, Bethalto, IL 62010-1777 |
Michael J Wilson | Family Medicine | Uptown Emergency Physicians, LLP | 159 E Mcarthur Dr, Bethalto, IL 62010-1777 |
Cayla Denise Wester | Nurse Practitioner | Uptown Emergency Physicians, LLP | 159 E Mcarthur Dr, Bethalto, IL 62010-1777 |
Karen L Ridenour | Nurse Practitioner | Uptown Emergency Physicians, LLP | 159 E Mcarthur Dr, Bethalto, IL 62010-1777 |
David A Berkenbile | Family Medicine | Maryville Physicians Services LLC | 159 E Mcarthur Dr, Bethalto, IL 62010-1777 |
Justin P Colanese | Orthopedic Surgery | Fairview Heights Medical Group Sc | 155 E Bethalto Dr, Bethalto, IL 62010-1801 |
Find all physicians in zip 62010 |
City | BETHALTO |
Zip Code | 62010 |
Specialty | PHYSICIAN ASSISTANT |
City + Specialty | BETHALTO + PHYSICIAN ASSISTANT |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.