| Theresa E Sullivan, DO, MPH | |
|
13250 Washington Ave, Mount Pleasant, WI 53177-1516 | |
| (262) 799-8700 | |
| Not Available |
| Full Name | Theresa E Sullivan |
|---|---|
| Gender | Female |
| Speciality | Hospitalist |
| Experience | 14 Years |
| Location | 13250 Washington Ave, Mount Pleasant, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447539655 | NPI | - | NPPES |
| 100040719 | Medicaid | WI | |
| 032.0109679 | Other | VT | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 125060039 (Illinois) | Secondary |
| 207R00000X | Internal Medicine | 62926 (Wisconsin) | Secondary |
| 208M00000X | Hospitalist | 62926 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Aurora Medical Center Kenosha | Kenosha, WI | Hospital |
| Aurora Lakeland Medical Center | Elkhorn, WI | Hospital |
| Aurora St Lukes Medical Center | Milwaukee, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Baycare Aurora Llc | 0244130557 | 187 |
| Aurora Medical Group, Inc. | 6709794258 | 3491 |
| Entity Name | Aurora Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| Entity Name | Baycare Aurora Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255387726 PECOS PAC ID: 0244130557 Enrollment ID: O20051012000579 |
| Mailing Address | Practice Location Address |
|---|---|
| Theresa E Sullivan, DO, MPH Po Box 735044, Chicago, IL 60673-5044 Ph: (414) 649-6000 | Theresa E Sullivan, DO, MPH 13250 Washington Ave, Mount Pleasant, WI 53177-1516 Ph: (262) 799-8700 |
Sachin H. Panchal, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 3807 Spring St, Mount Pleasant, WI 53405 Phone: 262-687-4011 | |
Saloni Jaiswal, Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 13250 Washington Ave, Mount Pleasant, WI 53177 Phone: 262-799-8700 | |
Osman Ahmedtaha, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 13250 Washington Ave, Mount Pleasant, WI 53177 Phone: 262-799-8700 | |
Ali Taha Hamoudi Hamoudi, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 13250 Washington Ave, Mount Pleasant, WI 53177 Phone: 888-720-2012 | |
Farah Faridi, Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 3801 Spring St, Mount Pleasant, WI 53405 Phone: 847-316-4000 |