Provider Demographics
NPI:1154317543
Name:SUTTON, CLAIRE N (MD)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:N
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11258 S ROUTE 59
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8090
Mailing Address - Country:US
Mailing Address - Phone:630-689-4944
Mailing Address - Fax:630-717-0981
Practice Address - Street 1:11258 S ROUTE 59
Practice Address - Street 2:SUITE 3
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8090
Practice Address - Country:US
Practice Address - Phone:630-689-4944
Practice Address - Fax:630-717-0981
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2015-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036108338207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036108338Medicaid
IL2233203OtherBCBS PROVIDER ID
ILK37920Medicare PIN
K10196Medicare PIN
H86913Medicare UPIN