JACLYN ANN SULLIVAN
NPI 1700432424
Speech-Language Pathologist in Palos Park, IL
About Jaclyn Ann Sullivan NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACLYN ANN SULLIVAN (NPI 1700432424) is an individual speech-language pathologist provider in Palos Park, Illinois, licensed in Illinois (146.011457) and active in the NPI registry since August 2019.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jaclyn Ann Sullivan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jaclyn Sullivan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Palos Park, IL 60464
- Reassigned Medicare billing, Illinois enrollment
- 2 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Jaclyn Sullivan's NPI number?
The NPI number for Jaclyn Sullivan is 1700432424. It was assigned to this individual provider in the NPPES registry on August 18, 2019.
Where is Jaclyn Sullivan located?
Jaclyn Sullivan practices at 12910 S La Grange Rd, Palos Park, IL 60464. The listed phone number is (708) 448-1234.
What is Jaclyn Sullivan's specialty?
The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.
Is Jaclyn Sullivan enrolled in Medicare?
Yes. Jaclyn Sullivan is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jaclyn Sullivan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jaclyn Sullivan reassigns Medicare benefits to Jadan Group Ltd (Palos Park, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jaclyn Sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jaclyn Sullivan was last updated on April 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Jaclyn Ann Sullivan · NPI 1700432424
Speech-Language Pathologist provider in Palos Park, Illinois. Individual provider, active in the CMS NPPES registry since August 18, 2019.
## Identity
- **NPI:** 1700432424 (Entity type: Individual)
- **Enumerated:** August 18, 2019
- **Primary specialty:** Speech-Language Pathologist · taxonomy 235Z00000X
- **State license:** 146.011457 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 12910 S LA GRANGE RD, Palos Park, IL 60464-1717
- **Phone:** (708) 448-1234
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Jadan Group Ltd (NPI 1932526944, Palos Park, IL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 24, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1700432424) · Data from the CMS NPPES public registry.