KENNETH P SULLIVAN


Address: 1416c South Randall Road, Randall Square Shopping Center, Geneva, IL 60134-4682
Phone: 6302089325

KENNETH P SULLIVAN (NPI# 1619929478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619929478
Entity Type Individual
Full Name KENNETH P SULLIVAN
Credential MD
Practice Address 1416c South Randall Road
Randall Square Shopping Center
Geneva
IL 60134-4682
Mailing Address 1121 Lake Cook Road
Suite M
Deerfield
IL 60015-5234
Practice Telephone 6302089325
Practice Fax Number 6302089326
Mailing Telephone 8479454550
Mailing Fax Number 8479488103
Enumeration Date 2006-05-17
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
X 2085N0700X Radiology
Specialization: Neuroradiology
IL Allopathic & Osteopathic Physicians
X 2085R0202X Radiology
Specialization: Diagnostic Radiology
IL Allopathic & Osteopathic Physicians

Other Providers KENNETH SULLIVAN

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1184840761 Kenneth Edward Sullivan Chiropractor 2056 Dauphin St, Mobile, AL 36606-1929 2007-04-18
1932256302 Kenneth P. Sullivan Psychologist 1104 Gleneagles Dr Sw # B, Huntsville, AL 35801-6404 2007-01-05
1740367598 Kenneth James Sullivan Dentist 928 Arnold Ave, Point Pleasant Boro, NJ 08742-2305 2006-11-01
1689756272 Kenneth Sullivan Dentist 2439 Bloomfield Rd, Cape Girardeau, MO 63703-6415 2006-10-20
1376637215 Kenneth W Sullivan Family Medicine 3511 Old Clarksville Pike, Joelton, TN 37080-8892 2006-10-03
1245345222 Kenneth Sullivan Psychologist 3900 Woodland Ave, Philadelphia, PA 19104-4551 2006-08-20
1902899917 Kenneth Sullivan Emergency Medicine 225 Memorial Dr, Berlin, WI 54923-1243 2005-08-24

Office Location

Street Address 1416C SOUTH RANDALL ROAD
RANDALL SQUARE SHOPPING CENTER
City GENEVA
State IL
Zip Code 60134-4682

Providers in the same location

NPI Name Taxonomy Address Enumeration
1902857881 Randallwood Radiology Associates, S. C. Radiology 1416c South Randall Road, Randall Square Shopping Center, Geneva, IL 60134 2006-05-15
1649383910 Provena Imaging Services Inc Radiology 1416c South Randall Road, Geneva, IL 60134 2006-08-17
1023058641 Brian Schwartz Radiology 1416c South Randall Road, Randall Square Shopping Center, Geneva, IL 60134-4682 2006-06-08

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902403918 Glenda Creighton Physical Therapist 0n 801 Friendship Way, Geneva, IL 60134 2020-10-02
1467912212 Cierra Monae French Family Medicine Northwestern Medicine Delnor Hospital, 300 Randall Road, Geneva, IL 60134 2019-03-20
1497246227 Linda Huber Psychologist 1541 E Fabyan Pkwy Ste 101, Geneva, IL 60134 2018-05-29
1003305459 Nicole Collins Specialist/Technologist 1125 Lewis Road, Geneva, IL 60134 2018-05-01
1013438704 Emily Byars Clinic/Center 1111 Greenfield Circle, Geneva, IL 60134 2017-07-03
1982142980 Samantha Courtney Counselor 1120 Randall Ct., Geneva, IL 60134 2017-02-09
1073055026 Physical Rehabilitation Clinics Physical Therapist 507 S. 3rd St. Unit I, Geneva, IL 60134 2016-11-08
1265868707 Gina Marie Gilchrist Dietitian, Registered 39w479 W Haladay Ln, Geneva, IL 60134 2013-09-16
1770823585 William A. Goodfellow General Practice 1010 S. Batavia Ave., Geneva, IL 60134 2013-02-15
1467705392 Kylie L Mack Physician Assistant 351 Delnor Dr #100, Geneva, IL 60134 2012-10-16
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Taxonomy Information

Taxonomy Code 2085N0700X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Neuroradiology

Taxonomy Definition

A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1740231364 Neeraj B Chepuri Radiology 825 W State St Ste 103e, Geneva, IL 60134-2078 2006-05-16

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1235736463 Melih Akyuz Radiology 1653 W Congress Pkwy Ste 181, Chicago, IL 60612-3833 2020-10-01
1891225256 Anoop Chacko Achanaril Radiology 1653 W. Congress Parkway, Jelke 181, Chicago, IL 60612 2017-06-18
1528224045 Corey Steven Bregman Radiology 2300 Childrens's Plaza, No. 9, Children's Memorial Hospital, Chicago, IL 60614-3363 2008-08-04
1780861807 Qasim Bashir Radiology 912 S. Wood St. M/c 799, Chicago, IL 60612 2008-01-31
1184771073 Tamara Jackson Radiology 469 W Huron St, Apt 810, Chicago, IL 60654-3467 2007-01-04
1548325897 Sasan Payvar Radiology 333 N. Madison Ave., Joliet, IL 60435 2006-12-27
1740376383 Anthony Wing-yui Kam Radiology 2160 S. First Ave, Dept of Neurological Surgery, Maywood, IL 60153-3328 2006-10-04
1285740043 Benjamin P Liu Radiology 676 N Saint Clair St Fl 14, Dept Neuroradiology, Chicago, IL 60611-2951 2006-08-22
1508801697 Glen Geremia Radiology 40 N Airlite St, Suite 4, Elgin, IL 60123-4965 2006-06-20
1790726495 Hamid Mohazab Radiology 1122 N Dearborn St, Chicago, IL 60610-5057 2006-06-10
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Competitor

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City GENEVA
Zip Code 60134

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Dataset Information

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.

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