Provider Demographics
NPI:1316008543
Name:NAHM, SUZANNE M (PTA)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:M
Last Name:NAHM
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 160TH ST
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-6718
Mailing Address - Country:US
Mailing Address - Phone:708-906-7562
Mailing Address - Fax:708-532-2094
Practice Address - Street 1:7800 160TH ST
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-6718
Practice Address - Country:US
Practice Address - Phone:708-906-7562
Practice Address - Fax:708-532-2094
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant