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NPI Code Detail

MEDICARE: DR. GERALD D SUCHOMSKI M.D.

MEDICARE: DR. GERALD D SUCHOMSKI M.D.
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
1207Q00000XFamily Medicine PhysicianIL

General Provider Information

NPI Number : 1538133350
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GERALD D SUCHOMSKI M.D.
Provider Business Mailing Address
First Line : 101 E PLUMMER BLVD
Second Line :
City : CHATHAM
State : IL
Zip : 62629-8047
Country : US
Telephone Number : 217-483-3487
Fax Number : 217-483-8150
Provider Business Practice Location Address
First Line : 101 E PLUMMER BLVD
Second Line :
City : CHATHAM
State : IL
Zip : 62629-8047
Country : US
Telephone Number : 217-483-3487
Fax Number : 217-483-8150
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2006
Last Update Date : 07/08/2007

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