Healthcare Provider Details

I. General information

NPI: 1508735648
Provider Name (Legal Business Name): DYMOND SULYMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20280 GOVERNORS HWY STE 106
OLYMPIA FIELDS IL
60461-1068
US

IV. Provider business mailing address

20280 GOVERNORS HWY STE 106
OLYMPIA FIELDS IL
60461-1068
US

V. Phone/Fax

Practice location:
  • Phone: 708-729-9006
  • Fax:
Mailing address:
  • Phone: 708-729-9006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number041448080
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: