Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michael J Sullivan, PA-C

Individual provider Physician Assistant · NPI 1881097236

Michael J Sullivan, PA-C is a Physician Assistant in Belleville, Illinois. Qualified in 2014, 12 years ago. Practices with Fairview Heights Medical Group SC, a 448-clinician group and accepts Medicare assignment.

Years since qualifying
12
In the registry since
2014
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4700 Memorial Dr Ste 340
Belleville, IL 62226-5373
Phone: (618) 234-9884
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1881097236
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 30, 2014
Last updated in NPPESFebruary 28, 2021
Certification dateFebruary 28, 2021
Mailing address4500 Memorial Drive, Memorial Hospital Medical Affairs, Belleville, IL 62226

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Fairview Heights Medical Group Sc — 448 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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