Provider Demographics
NPI:1366626426
Name:SUN, PATRICIA K (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:K
Last Name:SUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 S ARLINGTON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3765
Mailing Address - Country:US
Mailing Address - Phone:847-439-1005
Mailing Address - Fax:847-439-7555
Practice Address - Street 1:1415 S ARLINGTON HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3765
Practice Address - Country:US
Practice Address - Phone:847-439-1005
Practice Address - Fax:847-439-7555
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036115335207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-115335Medicaid
ILIL3509019Medicare PIN
ILIL3510019Medicare PIN
ILIL3511019Medicare PIN