Healthcare Provider Details

I. General information

NPI: 1154317543
Provider Name (Legal Business Name): CLAIRE N SUTTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 08/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11258 S ROUTE 59 SUITE 3
NAPERVILLE IL
60564-8090
US

IV. Provider business mailing address

11258 S ROUTE 59 SUITE 3
NAPERVILLE IL
60564-8090
US

V. Phone/Fax

Practice location:
  • Phone: 630-689-4944
  • Fax: 630-717-0981
Mailing address:
  • Phone: 630-689-4944
  • Fax: 630-717-0981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036108338
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: