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General NPI Number Information
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NPI Number | 1730724451
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Entity Type | Individual
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Provider Name | SUZANA DRAGINIS FPA-APRN, AGNP,IFMCP
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Gender | Female
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Dates
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Enumeration Date | 11/18/2019
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 825 S WAUKEGAN RD
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City | LAKE FOREST
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State | IL
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Zip | 60045-2696
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Country | US
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Telephone | 815-405-7137
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Fax | 833-800-0135
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Provider Business Mailing Address
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Address Line | 825 S WAUKEGAN RD STE A8
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City | LAKE FOREST
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State | IL
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Zip | 60045-2665
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Country | US
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Telephone | 815-405-7137
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Fax | 833-800-0135
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 277.003847
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License Number State | IL
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