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General NPI Number Information
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NPI Number | 1457090441
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Entity Type | Individual
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Provider Name | ERIN SULLIVAN MACDADE DNP
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Gender | Female
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 12/12/2022
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Provider Practice Location Address
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Address Line | 1725 W HARRISON ST STE 1010
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City | CHICAGO
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State | IL
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Zip | 60612-3841
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Country | US
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Telephone | 312-942-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 2480 N MILWAUKEE AVE APT 631
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City | CHICAGO
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State | IL
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Zip | 60647-2276
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Country | US
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Telephone | 563-543-4876
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209.025151
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License Number State | IL
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