Heather Maureen Sullivan, L. AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

198.000967 Issued in IL

Practice address

495 N Riverside Dr Ste 104
Gurnee, IL 60031-5919

Phone

(224) 440-7373

Fax

(847) 543-1512

NPI assigned

Feb 10, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1275839102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 N RIVERSIDE DR STE 104",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315919",
            "telephone_number": "224-440-7373",
            "fax_number": "847-543-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N RIVERSIDE DR STE 104",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315919",
            "telephone_number": "224-440-7373",
            "fax_number": "847-543-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "HEATHER",
        "middle_name": "MAUREEN",
        "credential": "L. AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-10",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "198.000967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Acupuncturist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.