Provider Demographics
NPI:1356370860
Name:STEINRUECK, SUZANNE PEREZ (RN)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:PEREZ
Last Name:STEINRUECK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4828 SARATOGA AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-3533
Mailing Address - Country:US
Mailing Address - Phone:773-870-1055
Mailing Address - Fax:773-409-2987
Practice Address - Street 1:4710 N TROY ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-4423
Practice Address - Country:US
Practice Address - Phone:773-870-1055
Practice Address - Fax:773-409-2987
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X
IL163W00000X, 163WN1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133N00000XDietary & Nutritional Service ProvidersNutritionist
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WN1003XNursing Service ProvidersRegistered NurseNutrition Support