MEDICARE: DR. DANNY HIROSHI SUGIMOTO MD

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	207R00000X	Internal Medicine Physician		IL

General Provider Information

NPI Number	:	1679661821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANNY HIROSHI SUGIMOTO MD

Provider Business Mailing Address
First Line	:	800 S WELLS ST
Second Line	:	SUITE M-15
City	:	CHICAGO
State	:	IL
Zip	:	60607-4529
Country	:	US
Telephone Number	:	312-431-6765
Fax Number	:	312-431-7959

Provider Business Practice Location Address
First Line	:	800 S WELLS ST
Second Line	:	SUITE M-15
City	:	CHICAGO
State	:	IL
Zip	:	60607-4529
Country	:	US
Telephone Number	:	312-431-6765
Fax Number	:	312-431-7959

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	07/08/2007

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