| Doctor Name: | MS. MARY THERESA O'SULLIVAN |
| NPI Number: | 1063736718 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 209007963 |
| Business Practice Address: | 5000 S 5th Ave Hines, IL - 601413030 |
| Business Phone Number: | 7082025988 |
| Business Fax Number: | |
| Mailing Address: | 5000 S 5th Ave, HINES |
| State: | IL |
| Postal Code: | 601413030 |
| Phone Number: | 7082025988 |
| Fax Number: | |
| NPI Enumeration Date: | 03/24/2010 |
| NPI Last Update Date: | 02/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NC0060X |
| License Number: | 209007963 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Critical Access |
| Taxonomy Definition: | |