Provider Demographics
NPI:1831456680
Name:FLOOD, SUZANNE MARTHA (RN, ANP)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MARTHA
Last Name:FLOOD
Suffix:
Gender:F
Credentials:RN, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-2503
Mailing Address - Country:US
Mailing Address - Phone:847-475-7077
Mailing Address - Fax:
Practice Address - Street 1:2611 W CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-4519
Practice Address - Country:US
Practice Address - Phone:773-395-9901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209002696363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner