| Jaclyn Ann Sullivan, | |
|
12910 S La Grange Rd, Palos Park, IL 60464-1717 | |
| (708) 448-1234 | |
| Not Available |
| Full Name | Jaclyn Ann Sullivan |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 12910 S La Grange Rd, Palos Park, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700432424 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 146.011457 (Illinois) | Primary |
| 237700000X | Hearing Instrument Specialist | 2676 (Illinois) | Secondary |
| Provider Name | Jadan Group Ltd |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1932526944 PECOS PAC ID: 0648499228 Enrollment ID: O20140912001147 |
| Mailing Address | Practice Location Address |
|---|---|
| Jaclyn Ann Sullivan, 12910 S La Grange Rd, Palos Park, IL 60464-1717 Ph: (708) 448-1234 | Jaclyn Ann Sullivan, 12910 S La Grange Rd, Palos Park, IL 60464-1717 Ph: (708) 448-1234 |
Emilee Anne Caldwell, Speech-Language Pathologist Medicare: Accepting Medicare Assignments Practice Location: 10300 Village Circle Dr, Palos Park, IL 60464 Phone: 708-361-3683 |
Patrice Leann Alfini, MS Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 12700 S 104th Ave, Palos Park, IL 60464 Phone: 708-448-6888 |
Mrs. Stacey Ann Carroll, MA CCC SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 10550 Ridgewood Dr, Palos Park, IL 60464 Phone: 773-742-9817 Fax: 312-506-5333 |
Mrs. Ruta Grigas, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 7942 W 121st St, Lets Talk Speech Therapy, Palos Park, IL 60464 Phone: 708-217-2629 Fax: 708-361-5410 |
Bridget Ann Boam, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 8800 W 119th St, Palos Park, IL 60464 Phone: 708-448-4800 |
Amy A Andereck, MA-CCC/SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 12408 S Hobart St, Palos Park, IL 60464 Phone: 708-448-3637 Fax: 708-448-4610 |
Sheila Stull, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 8800 W 119th St, Palos Park, IL 60464 Phone: 708-448-4800 |