Active NPI
Kevin Michael O'Sullivan, ATC/L, CSCS
- Athletic Trainer
- Elk Grove Village, IL
National Provider Identifier
1952389959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096001761
- Practice address
- 120 E. Higgins Rd
Elk Grove Village, IL 60007-3657 - Phone
- (847) 285-4210
- NPI assigned
- Jan 9, 2006
- Last updated
- Mar 14, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096001761 | IL | Primary |
Addresses
Primary practice location
120 E. Higgins Rd
Elk Grove Village, IL 60007-3657
Mailing address
448 N Stark Dr
Palatine, IL 60074-3825
Phone (847) 359-8202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096001761 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331683200000",
"number": "1952389959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "448 N STARK DR",
"city": "PALATINE",
"state": "IL",
"postal_code": "600743825",
"telephone_number": "847-359-8202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 E. HIGGINS RD",
"city": "ELK GROVE VILLAGE",
"state": "IL",
"postal_code": "600073657",
"telephone_number": "847-285-4210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'SULLIVAN",
"first_name": "KEVIN",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "ATC/L, CSCS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-09",
"last_updated": "2012-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096001761",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove Village, IL
- Marilyn Janet Nunez, APN
- Nur Vision LLC
- Thomas Fitzgerald O'Connell, MD
- Teresa O'Donnell, APN
- Charles J O'Laughlin Jr., MD
- OB-Gyne& Infertility Center, S.C. (Multispecialty Clinic)
- Elizabeth Obrien
- Jessica Marie Ocampo
- Occupational Health Centers of Illinois PC (Concentra Medical Center)
- Occupational Health Centers of Illinois PC (Concentra Medical Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.