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NPI Code Detail

MEDICARE: SUSAN SARRAN M.D.

MEDICARE: SUSAN SARRAN M.D.
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 Physician036-068252IL

General Provider Information

NPI Number : 1952312340
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN SARRAN M.D.
Provider Business Mailing Address
First Line : 701 LEE ST
Second Line : SUITE 300
City : DES PLAINES
State : IL
Zip : 60016-4539
Country : US
Telephone Number : 847-390-5900
Fax Number :
Provider Business Practice Location Address
First Line : 6434 W NORTH AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60707-4030
Country : US
Telephone Number : 773-836-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 11/21/2012

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