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General NPI Number Information
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NPI Number | 1235505553
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Entity Type | Individual
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Provider Name | CAROLINE SUBA FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/20/2015
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 1702 N MILWAUKEE AVE
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City | CHICAGO
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State | IL
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Zip | 60647-5424
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Country | US
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Telephone | 773-770-4056
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Fax | 773-227-7219
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Provider Business Mailing Address
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Address Line | 635 N FAIRBANKS CT
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City | CHICAGO
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State | IL
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Zip | 60611-5435
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Country | US
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Telephone | 312-694-2273
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Fax | 312-472-3176
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209013176
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License Number State | IL
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