Provider Demographics
NPI:1114952256
Name:FLOM, L. SUZANNE (MD)
Entity Type:Individual
Prefix:MS
First Name:L.
Middle Name:SUZANNE
Last Name:FLOM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8901 GOLF RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-6850
Mailing Address - Country:US
Mailing Address - Phone:847-297-8700
Mailing Address - Fax:847-297-8760
Practice Address - Street 1:8901 GOLF RD
Practice Address - Street 2:SUITE 301
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-6850
Practice Address - Country:US
Practice Address - Phone:847-297-8700
Practice Address - Fax:847-297-8760
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL0360716442088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036071644Medicaid