MEDICARE: PHILLIPPI ANQUAIN SULLIVAN PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5581	SC

General Provider Information

NPI Number	:	1942231253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILLIPPI ANQUAIN SULLIVAN PT

Provider Business Mailing Address
First Line	:	2001 BUTTERFIELD RD STE 1600
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 MEDICAL PKWY
Second Line	:	SUITE 150
City	:	GREER
State	:	SC
Zip	:	29650-2456
Country	:	US
Telephone Number	:	864-797-9600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	02/11/2025

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