Healthcare Provider Details

I. General information

NPI: 1215034525
Provider Name (Legal Business Name): SUE C. TOBIN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUE C. KULINSKI

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL LN STE 300
DANVILLE IN
46122-2000
US

IV. Provider business mailing address

1100 SOUTHFIELD DR STE 1370
PLAINFIELD IN
46168-4300
US

V. Phone/Fax

Practice location:
  • Phone: 317-520-5510
  • Fax: 317-386-5539
Mailing address:
  • Phone: 317-837-5566
  • Fax: 317-837-5567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number0049170
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number02004537A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number5101013923
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberDR-49170
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: