DR. TIMOTHY P SULLIVAN (NPI# 1396819215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396819215 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY P SULLIVAN |
| Credential | D.D.S. |
| Practice Address |
370 W Terra Cotta Ave Crystal Lake IL 60014-3512 |
| Practice Telephone | 8154592180 |
| Practice Fax Number | 8154592181 |
| Mailing Telephone | 8154592180 |
| Mailing Fax Number | 8154592181 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063024792 | Timothy Sullivan | Specialist/Technologist | 601 E Elm St Apt 1203, Troy, AL 36081-3498 | 2020-08-24 |
| 1215585112 | Timothy Sullivan II | Massage Therapist | 318 E Maiden St, Washington, PA 15301-5108 | 2019-09-04 |
| 1972954675 | Timothy Sullivan | Technician/Technologist | 38 Thatcher St, Rumford, RI 02916-2714 | 2016-06-24 |
| 1982019840 | Timothy Paul Sullivan | Chiropractor | 17000 E Us Highway 40 Ste 7, Independence, MO 64055-5394 | 2014-06-30 |
| 1306110176 | Timothy Coleman Sullivan | Behavioral Analyst | 7291 Garden Grove Blvd, Suite F, Garden Grove, CA 92841-4211 | 2012-02-26 |
| 1235452343 | Timothy Sullivan | Pharmacist | 336 Route 202, Somers, NY 10589-3220 | 2010-03-03 |
| 1619152915 | Timothy Mark Sullivan | Physician Assistant | 9951 E El Moro Ave, Mesa, AZ 85208-5869 | 2008-01-04 |
| 1154408011 | Timothy Patrick Sullivan | Otolaryngology | 19 N Rivers Edge Dr, Little Silver, NJ 07739-1710 | 2006-10-31 |
| 1881786226 | Timothy Joseph Sullivan | Pediatrics | 92 New London Tpke, Norwich, CT 06360 | 2006-09-29 |
| 1679559488 | Timothy E Sullivan | Chiropractor | 6101 Windcom Ct, Suite 300, Plano, TX 75093-7817 | 2005-12-22 |
| Street Address |
370 W TERRA COTTA AVE |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60014-3512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497394720 | Lorelei Mariano | Physical Therapist | 350 E Congress Parkway Ste A, Crystal Lake, IL 60014 | 2020-01-03 |
| 1396227070 | Behavioral Services for Autism, Inc | Behavioral Analyst | 1095 Pingree Road, Suite 204, Crystal Lake, IL 60014 | 2018-08-30 |
| 1831635564 | Isis Mendoza-garnica | Counselor | 6803 Rose Ave, Crystal Lake, IL 60014 | 2017-01-19 |
| 1134664402 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 525 E Congress Parkway, Suite 200, Crystal Lake, IL 60014 | 2016-12-22 |
| 1306394051 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 177 W Virginia Street, Crystal Lake, IL 60014 | 2016-09-12 |
| 1124492830 | Align Spine & Orthopaedics | Durable Medical Equipment & Medical Supplies | 60 B West Terra Cotta Ave, #265, Crystal Lake, IL 60014 | 2015-11-18 |
| 1558747428 | Shabana Nawaz | Optometrist | 4777 Northwest Highway, Crystal Lake, IL 60014 | 2015-08-03 |
| 1548649205 | Daniel Okon | Social Worker | 304 Charllote Ave, Crystal Lake, IL 60014 | 2015-05-27 |
| 1154729838 | Crystal Lake Center for Chronic Pain Sc | Nurse Practitioner | 1 South Northwest Highway, Crystal Lake, IL 60014 | 2014-12-12 |
| 1558763581 | Brooke Nicole Grandt | Occupational Therapist | 394 Heisler Ct, Crystal Lake, IL 60014 | 2014-09-22 |
| Find all providers in zip 60014 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982058848 | Zarasmita Dmd LLC | Dentist | 1560 Carlemont Dr, Crystal Lake, IL 60014-2740 | 2016-04-18 |
| 1720259013 | Gregory V. Sierminski, D.d.s., P.C. | Dentist | 7442 Hancock Drive, Crystal Lake, IL 60097 | 2008-03-14 |
| 1669539904 | Procare Dental Group, P.C. | Dentist | 805 Mchenry Ave, Crystal Lake, IL 60014-9794 | 2007-01-03 |
| 1649348418 | Ofelia Mirela Pod | Dentist | 1520 Carlemont Dr, Suite E, Crystal Lake, IL 60014-1834 | 2006-12-01 |
| 1861565871 | Dr Paul A Bruggeman Dds PC | Dentist | 17 S Virginia, Crystal Lake, IL 60014 | 2006-11-16 |
| 1275606287 | Kevin M Bruggeman | Dentist | 17 S Virginia Road, Crystal Lake, IL 60014 | 2006-11-16 |
| 1417033150 | Gregory Frank Kubik | Dentist | 490 Coventry Ln, Suite 200, Crystal Lake, IL 60014-7548 | 2006-10-27 |
| 1467537332 | Joseph I Frazier | Dentist | 690 N. Route 31, College Hill Professional Building, Crystal Lake, IL 60012 | 2006-10-26 |
| 1700978772 | Perfect Choice Dental, P.C. | Dentist | 284 Memorial Court, Suite A, Crystal Lake, IL 60014-6231 | 2006-09-28 |
| 1285732438 | Kathleen Ann Schroeder | Dentist | 278 Memorial Drive, Crystal Lake, IL 60014-6254 | 2006-09-20 |
| Find all providers in CRYSTAL LAKE | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
Please comment or provide details below to improve the information on DR. TIMOTHY P SULLIVAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.