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SAVANNAH MAE SULLIVAN PA-C
NPI 1124624671
Physician Assistant in Northbrook, IL

Active since December 09, 2020PECOS Enrolled
333 SKOKIE BLVD STE 108-109, NORTHBROOK, IL 60062(847) 450-6393(847) 919-8375 Get Directions Write a Review

NPPES record last updated: September 3, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 3, 2025, Aug 7, 2025, Jan 15, 2023 and 3 more (6 updates tracked since 2020).

About Savannah Mae Sullivan Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAVANNAH MAE SULLIVAN PA-C (NPI 1124624671) is an individual physician assistant in Northbrook, Illinois, licensed in Illinois (085.008952) and active in the NPI registry since December 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1124624671
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSAVANNAH MAE SULLIVANCredential: PA-C
Location Address333 SKOKIE BLVD STE 108-109Northbrook, IL 60062-1613
Mailing Address4247 S Valentina BaySalt Lake City, UT 84107-3394 · (937) 360-7940
Phone(847) 450-6393
Fax(847) 919-8375
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateDecember 9, 2020
Last NPPES UpdateSeptember 3, 20256 updates tracked since enumeration
NPPES CertifiedSeptember 3, 2025
✔ NPI 1124624671 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in IL · 085.008952✔ Licensed in OH · 50.007504RX
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
333 SKOKIE BLVD STE 108-109, Northbrook, IL 60062
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Savannah Mae Sullivan Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3779951256
PECOS Enrollment IDI20221115002526
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60062 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRACY JOANN BUCHMAN EVANS
Counselor (Mental Health)
333 SKOKIE BLVD STE 108-109
NORTHBROOK, IL 60062
Cook County (847) 450-6393
MR. JUSTIN WING HANG LEE PA-C, CAQ-PSYCH
Physician Assistant
333 SKOKIE BLVD STE 108-109
NORTHBROOK, IL 60062
Cook County (847) 450-6393

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Savannah Sullivan's NPI number?

The NPI number for Savannah Sullivan is 1124624671. It was assigned to this individual provider in the NPPES registry on December 9, 2020.

Where is Savannah Sullivan located?

Savannah Sullivan practices at 333 Skokie Blvd Ste 108-109, Northbrook, IL 60062. The listed phone number is (847) 450-6393.

What is Savannah Sullivan's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Savannah Sullivan enrolled in Medicare?

Yes. Savannah Sullivan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Savannah Sullivan was last updated on September 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.