Evan B Suan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036088529 Issued in IL

Practice address

6720 167TH St
Tinley Park, IL 60477-2872

Phone

(708) 429-1600

Fax

(708) 429-7216

NPI assigned

Jul 5, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: esuan279837@direct.myadvocateaurora.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ebs Pediatrics

  • Pediatrics Physician
  • Tinley Park, IL
  • NPI 1184679979
  NPD (past) Authorized official

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1457358574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6720 167TH ST",
            "address_2": "UNIT 3",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772872",
            "telephone_number": "708-429-1600",
            "fax_number": "708-429-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6720 167TH ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772872",
            "telephone_number": "708-429-1600",
            "fax_number": "708-429-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAN",
        "first_name": "EVAN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036088529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088529",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin A. Strausbaugh, APN-CNP
• Strive ABA Consultants LLC
• Kristina Stuedemann, DMD
• Jill Stulga, MPT
• Ronald S Stumbris, MD
• Suburban Pain Care Surgical Facility LLC
• Suburban Surgical Facility
• Serah Sulaiman
• Mohammad Suleiman, PHARMD
• Mohammad Suleiman

• Pediatrics Physician in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; 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.