Provider Demographics
NPI:1922063569
Name:HAKIM, SUCHINTA (MD)
Entity Type:Individual
Prefix:
First Name:SUCHINTA
Middle Name:
Last Name:HAKIM
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 1:39182 TREASURY CTR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60694-9000
Mailing Address - Country:US
Mailing Address - Phone:630-734-0200
Mailing Address - Fax:
Practice Address - Street 1:120 N OAK ST
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3829
Practice Address - Country:US
Practice Address - Phone:630-856-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036058651207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036058651Medicaid
ILK09223Medicare UPIN
ILL59152Medicare ID - Type Unspecified
IL036058651Medicaid
ILK09221Medicare UPIN
ILK09222Medicare UPIN