Park, Sue M

Park, Sue M is an individual health care provider with primary practice located at 225 E Chicago Ave # 19 , Chicago IL 60611-2991. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Park, Sue M can be contacted via phone (312) 227-5157.

Contact Information

Primary practice address
225 E Chicago Ave # 19 Chicago IL 60611-2991
Phone: (312) 227-5157
Fax: (312) 227-9730
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 209.007061041.336475 Illinois

Profile Details

NPI number 1578700522
LBN Legal business name Park, Sue M
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2009
Last updated Feb 4th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578700522 NPPES
Illinois MEDICAID 1801058086
Illinois MEDICAID 1578700522

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