MEDICARE: SUZANNE PEREZ STEINRUECK R.N.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	133N00000X	Nutritionist
2	163W00000X	Registered Nurse	IL
3	163WN1003X	Nutrition Support Registered Nurse	IL

General Provider Information

NPI Number	:	1356370860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE PEREZ STEINRUECK R.N.

Provider Business Mailing Address
First Line	:	4828 SARATOGA AVE
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-3533
Country	:	US
Telephone Number	:	773-870-1055
Fax Number	:	773-409-2987

Provider Business Practice Location Address
First Line	:	4710 N TROY ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-4423
Country	:	US
Telephone Number	:	773-870-1055
Fax Number	:	773-409-2987

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	09/11/2025

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