Provider Demographics
NPI:1235505553
Name:SUBA, CAROLINE (FNP-C)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:SUBA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:HOKL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2645 W HOMER STREET
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647
Mailing Address - Country:US
Mailing Address - Phone:847-337-6768
Mailing Address - Fax:
Practice Address - Street 1:1702 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647
Practice Address - Country:US
Practice Address - Phone:773-770-4056
Practice Address - Fax:773-227-7219
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-20
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily