| James H Sullivan, MD | |
|
901 Grant Street, Harvard, IL 60033-1821 | |
| (815) 943-2693 | |
| (815) 943-0659 |
| Full Name | James H Sullivan |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 901 Grant Street, Harvard, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891805081 | NPI | - | NPPES |
| SULLIJAM | Other | WI | MERCYCARE INSURANCE |
| 1891805081 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 036-097083 (Illinois) | Primary |
| Entity Name | Rockford Health Physicians |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043242886 PECOS PAC ID: 2567374036 Enrollment ID: O20031103000584 |
| Entity Name | Mercy Health System Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598718603 PECOS PAC ID: 7416860440 Enrollment ID: O20031111000307 |
| Mailing Address | Practice Location Address |
|---|---|
| James H Sullivan, MD 901 Grant Street, Harvard, IL 60033-1821 Ph: (815) 943-2693 | James H Sullivan, MD 901 Grant Street, Harvard, IL 60033-1821 Ph: (815) 943-2693 |
Joseph H Levenstein, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 901 Grant St, Harvard, IL 60033 Phone: 815-943-5431 Fax: 815-943-0659 | |
Dr. Mohammad Amir, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 901 Grant St, Harvard, IL 60033 Phone: 815-943-5431 | |
David F Kavanaugh, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 901 Grant St, Harvard, IL 60033 Phone: 815-943-5431 Fax: 815-943-5460 | |
Victor I Garber, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 901 Grant St, Harvard, IL 60033 Phone: 815-943-5431 Fax: 815-943-0659 |