MEDICARE: MR. DAVID A SUTTON P.A. - C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	085-001486	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	970025829	OTHER		RAILROAD MEDICARE

General Provider Information

NPI Number	:	1083685572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID A SUTTON P.A. - C

Provider Business Mailing Address
First Line	:	2940 ROLLINGRIDGE RD
Second Line	:	SUITE 201
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-4231
Country	:	US
Telephone Number	:	630-967-6000
Fax Number	:	630-428-3971

Provider Business Practice Location Address
First Line	:	2940 ROLLINGRIDGE RD
Second Line	:	SUITE 201
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-4231
Country	:	US
Telephone Number	:	630-967-6000
Fax Number	:	630-428-3971

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	09/10/2012

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Directions to “ MR. DAVID A SUTTON P.A. - C” Practice Location

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