Provider Demographics
NPI:1972010031
Name:SUMA, SARAH A (MS, ACAGNP-BC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:SUMA
Suffix:
Gender:F
Credentials:MS, ACAGNP-BC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:KERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:251 E HURON ST STE 12-736
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2908
Mailing Address - Country:US
Mailing Address - Phone:312-926-2912
Mailing Address - Fax:312-926-7404
Practice Address - Street 1:251 E HURON ST STE 12-736
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:312-926-2912
Practice Address - Fax:312-926-7404
Is Sole Proprietor?:No
Enumeration Date:2018-01-10
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.422016163W00000X
IL209.017086363LA2100X
IL209017086363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care