Provider Demographics
NPI:1790773216
Name:ROSSMAN, SUELLYN S (MD)
Entity Type:Individual
Prefix:DR
First Name:SUELLYN
Middle Name:S
Last Name:ROSSMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2434 E DEMPSTER ST STE 206
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-5340
Mailing Address - Country:US
Mailing Address - Phone:847-297-2474
Mailing Address - Fax:847-297-2476
Practice Address - Street 1:2434 E DEMPSTER ST STE 206
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-5340
Practice Address - Country:US
Practice Address - Phone:847-297-2474
Practice Address - Fax:847-297-2476
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036042529207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C41906Medicare UPIN
IL474070Medicare ID - Type Unspecified