MEDICARE: JAMIE SUH

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	101YM0800X	Mental Health Counselor	178.022439	IL

General Provider Information

NPI Number	:	1790648764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE SUH

Provider Business Mailing Address
First Line	:	847 N HERMITAGE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-5061
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 E WASHINGTON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-1708
Country	:	US
Telephone Number	:	312-863-6200
Fax Number	:

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

Provider Enumeration Date	:	12/06/2025
Last Update Date	:	12/06/2025

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Directions to “ JAMIE SUH ” Practice Location

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