Physician Compare National (NPI:1942425590)

HEALTHCARE PROVIDER: SUSAN SUNG MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1942425590
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5698875003
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070714000125
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SUNG
	Individual professional last name
Provider First Name	SUSAN
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	THEDACARE INCORPORATED
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1759294887
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	449
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2500 E CAPITAL DR
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	APPLETON
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	549118735
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	520160
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	521355
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BERLIN MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	521346
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SHAWANO MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	521303
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	WILD ROSE COMMUNITY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	520045
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	THEDA CLARK MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1942425590)

HEALTHCARE PROVIDER: SUSAN SUNG MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information