Individual provider Active NPI

Suzanne Marie Kollias, REGISTERED NURSE

  • Registered Nurse
  • Schaumburg, IL
National Provider Identifier
1770362006
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041233454 Issued in IL
Practice address
1008 Portland Dr
Schaumburg, IL 60194-2234
Phone
(847) 208-4955
NPI assigned
Sep 26, 2023
Last updated
Sep 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041233454 IL Primary

Addresses

Primary practice location

1008 Portland Dr
Schaumburg, IL 60194-2234

Mailing address

41W400 Silver Glen Rd
St Charles, IL 60175-8453
Phone (630) 940-1157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
041233454ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Glen Road Opco LLC CurrentSince Oct 1, 2023 Accepting new patients

Locations

41W400 Silver Glen Rd
St Charles, IL 60175
Phone (331) 901-4225

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1770362006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41W400 SILVER GLEN RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601758453",
            "telephone_number": "630-940-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 PORTLAND DR",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601942234",
            "telephone_number": "847-208-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLIAS",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041233454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.