MEDICARE: MUTSUKO SUGITA

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
1	1041C0700X	Clinical Social Worker	149027458	IL

General Provider Information

NPI Number	:	1811852577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUTSUKO SUGITA

Provider Business Mailing Address
First Line	:	805 GREENWOOD ST
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-6521
Country	:	US
Telephone Number	:	224-420-7405
Fax Number	:

Provider Business Practice Location Address
First Line	:	805 GREENWOOD ST
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-6521
Country	:	US
Telephone Number	:	224-420-7405
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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Directions to “ MUTSUKO SUGITA ” Practice Location

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