Provider Demographics
NPI:1730647678
Name:SUGGS, LINNIE B
Entity Type:Individual
Prefix:
First Name:LINNIE
Middle Name:B
Last Name:SUGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-4458
Mailing Address - Country:US
Mailing Address - Phone:217-274-1209
Mailing Address - Fax:
Practice Address - Street 1:520 SHERMAN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-4458
Practice Address - Country:US
Practice Address - Phone:217-274-1209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist