Provider Demographics
NPI:1922868413
Name:ABREU, SUZANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:ABREU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 S DAMEN AVE APT 715
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-5592
Mailing Address - Country:US
Mailing Address - Phone:315-406-9382
Mailing Address - Fax:
Practice Address - Street 1:2215 OAK PARK AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-2220
Practice Address - Country:US
Practice Address - Phone:708-218-9642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.339071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice