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NPI Code Detail

MEDICARE: SUZANNE MARTHA FLOOD R.N, ANP

MEDICARE: SUZANNE MARTHA FLOOD R.N, ANP
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
1363L00000XNurse Practitioner209002696IL

General Provider Information

NPI Number : 1831456680
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE MARTHA FLOOD R.N, ANP
Provider Business Mailing Address
First Line : 741 FOREST AVE
Second Line :
City : EVANSTON
State : IL
Zip : 60202-2503
Country : US
Telephone Number : 847-475-7077
Fax Number :
Provider Business Practice Location Address
First Line : 2611 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60622-4519
Country : US
Telephone Number : 773-395-9901
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2012
Last Update Date : 04/18/2012

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Directions to “ SUZANNE MARTHA FLOOD R.N, ANP” Practice Location

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