Brendan D. Sullivan, MSW, L.C.S.W

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.015720 Issued in IL

Practice address

711 Devon Ave
Suite 203
Park Ridge, IL 60068-4713

Phone

(847) 650-7340

NPI assigned

Mar 5, 2013

Sex

Male

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": "1362441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1336480144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 S FAIRVIEW AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681216",
            "telephone_number": "847-650-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 DEVON AVE",
            "address_2": "SUITE 203",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684713",
            "telephone_number": "847-650-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRENDAN",
        "middle_name": "D.",
        "credential": "MSW, L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-05",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabella Suffian
• Patrick Alexander Sugrue, MD
• Rudy S Suidan, M.D., M.S.
• Sabah Maryam Sulaiman
• Saba Suleman, LCPC
• Frances Marie Sulzer, PSYCHOTHERAPIST
• Hibba Sumra, MD
• Amy F Sun, M.D.
• Michelle Lynn Sun, DO
• Sunova Healthcare S.C.

• Clinical Social Worker in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; 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.