Provider Demographics
NPI:1205362977
Name:SUING, KRISTEN (PSYD)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:SUING
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21419 S JEFFREY DR
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-2431
Mailing Address - Country:US
Mailing Address - Phone:612-382-2718
Mailing Address - Fax:
Practice Address - Street 1:600 S WASHINGTON ST STE 105
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6665
Practice Address - Country:US
Practice Address - Phone:630-206-4060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301016190103T00000X
IL071.010182103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist