MEDICARE: MS. SUHA Y ALI RN

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	163WC0200X	Critical Care Medicine Registered Nurse	041.467231	IL

General Provider Information

NPI Number	:	1700554706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUHA Y ALI RN

Provider Business Mailing Address
First Line	:	327 SOUTH BLVD
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60302-2921
Country	:	US
Telephone Number	:	708-676-0288
Fax Number	:

Provider Business Practice Location Address
First Line	:	327 SOUTH BLVD
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60302-2921
Country	:	US
Telephone Number	:	708-676-0288
Fax Number	:

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

Provider Enumeration Date	:	09/03/2021
Last Update Date	:	12/09/2025

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