Provider Demographics
NPI:1275573602
Name:SUD, ASHISH (DC)
Entity Type:Individual
Prefix:DR
First Name:ASHISH
Middle Name:
Last Name:SUD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25441 GROTTO CT
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-2582
Mailing Address - Country:US
Mailing Address - Phone:630-699-4255
Mailing Address - Fax:
Practice Address - Street 1:25441 GROTTO CT
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-2582
Practice Address - Country:US
Practice Address - Phone:630-699-4255
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor