Provider Demographics
NPI:1831387901
Name:STERLING, SUSAN (DN)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:STERLING
Suffix:
Gender:F
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 HITCHING POST LN
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-9628
Mailing Address - Country:US
Mailing Address - Phone:773-931-5630
Mailing Address - Fax:
Practice Address - Street 1:5906 39TH AVE
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53144-2738
Practice Address - Country:US
Practice Address - Phone:847-566-0003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-13
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL181.000328172P00000X
WI1831387901171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No172P00000XOther Service ProvidersNaprapathGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1831387901OtherLICENSE NUMBER