Provider Demographics
NPI:1558519561
Name:SUNDERMEIER, JOANNE THERESE (M,D,)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:THERESE
Last Name:SUNDERMEIER
Suffix:
Gender:F
Credentials:M,D,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12766 S HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-2145
Mailing Address - Country:US
Mailing Address - Phone:708-448-2626
Mailing Address - Fax:708-448-0630
Practice Address - Street 1:12766 S HARLEM AVE
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-2145
Practice Address - Country:US
Practice Address - Phone:708-448-2626
Practice Address - Fax:708-448-0630
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036080112208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics