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NPI Code Detail

MEDICARE: DR. MICHAEL J SUTHERLAND MD

MEDICARE: DR. MICHAEL J SUTHERLAND MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12086S0127XTrauma Surgery Physician35132228OH
22086S0127XTrauma Surgery Physician036160346IL
3208600000XSurgery Physician35132228OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083604821
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL J SUTHERLAND MD
Provider Business Mailing Address
First Line : 676 N SAINT CLAIR ST STE 650
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2929
Country : US
Telephone Number : 312-695-4835
Fax Number : 312-695-3644
Provider Business Practice Location Address
First Line : 676 N SAINT CLAIR ST STE 650
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2929
Country : US
Telephone Number : 312-695-4835
Fax Number : 312-695-3644
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 01/31/2023

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