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NPI Code Detail

MEDICARE: DR. MARIA DANA SUTKUS DO

MEDICARE: DR. MARIA DANA SUTKUS DO
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
1207Q00000XFamily Medicine Physician036082471IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
119621614OTHERILBC/BS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447243100
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARIA DANA SUTKUS DO
Provider Business Mailing Address
First Line : 1 E COUNTYLINE RD
Second Line :
City : SANDWICH
State : IL
Zip : 60548-2178
Country : US
Telephone Number : 815-786-2722
Fax Number : 815-786-6840
Provider Business Practice Location Address
First Line : 1 E COUNTYLINE RD
Second Line :
City : SANDWICH
State : IL
Zip : 60548-2178
Country : US
Telephone Number : 815-786-2722
Fax Number : 815-786-6840
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2005
Last Update Date : 03/08/2021

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Directions to “ DR. MARIA DANA SUTKUS DO” Practice Location

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