Marine Sutrisno, OTR/L

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

056009695 Issued in IL

Practice address

721 Crown CT
Schaumburg, IL 60193-3182

Phone

(312) 238-2460

NPI assigned

Jan 22, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1073902417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 CROWN CT",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601933182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 CROWN CT",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601933182",
            "telephone_number": "312-238-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTRISNO",
        "first_name": "MARINE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "IL",
            "license": "056009695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geetha Sunny
• Superior Pharmacy Solutions, Inc.
• Zara Surani, NP
• Rajesh P Surkar, OT
• Boguslawa L Susol, RD
• Ronald J Svoboda, D.D.S
• Donald Swager
• Jeffrey Scott Swager, D.D.S.
• Shariffer K Swain
• Kathryn Swanson, DPT

• Rehabilitation Clinic/Center in Schaumburg, IL
• Providers in Schaumburg, IL by specialty
• Rehabilitation Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.