Provider Demographics
NPI:1093303471
Name:FLECK, SUZANNE (PHARM D)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:FLECK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21043 LAKEWOODS LN
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60404-0606
Mailing Address - Country:US
Mailing Address - Phone:815-258-1837
Mailing Address - Fax:
Practice Address - Street 1:2375 DRAUDEN RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-2213
Practice Address - Country:US
Practice Address - Phone:815-577-0457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-01
Last Update Date:2021-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.291260183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist