Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 036.139637 | IL |
NPI | 1073951067 |
---|---|
Provider Name | Dr. Kaleigh Suhs |
First Address | Park Ridge, IL 60068-1005 |
Second Address | Park Ridge, IL 60068-1005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2013 |
Last Update Date | 07/07/2016 |