Healthcare Provider Details
I. General information
NPI: 1720491772
Provider Name (Legal Business Name): ASHLEY N SUAH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/07/2014
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5841 S MARYLAND AVE MC 6040
CHICAGO IL
60637-1447
US
IV. Provider business mailing address
150 HARVESTER DR STE 300
BURR RIDGE IL
60527-5965
US
V. Phone/Fax
- Phone: 773-753-1880
- Fax: 773-702-2140
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 204F00000X |
| Taxonomy | Transplant Surgery Physician |
| License Number | 036141417 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 036141417 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: