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NPI Code Detail

MEDICARE: NOOR KAPOOR SUSMA

MEDICARE: NOOR KAPOOR SUSMA
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
1363LF0000XFamily Nurse Practitioner209-033130IL

General Provider Information

NPI Number : 1619850518
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOOR KAPOOR SUSMA
Provider Business Mailing Address
First Line : 2427 W GRENSHAW ST APT 2
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4898
Country : US
Telephone Number : 630-415-6632
Fax Number :
Provider Business Practice Location Address
First Line : 1620 W HARRISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3801
Country : US
Telephone Number : 630-415-6632
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2025
Last Update Date : 03/10/2026

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Directions to “ NOOR KAPOOR SUSMA ” Practice Location

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