Thomas Hyung Jun Suh, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

90200000X Issued in IL

Practice address

815 Main St Ste C
Peoria, IL 61602-1080

Phone

(314) 297-6016

NPI assigned

Apr 2, 2025

Sex

Male

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: tsuh445015@carlehiedirect.net

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1912701533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 MAIN ST STE C",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 MAIN ST STE C",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021080",
            "telephone_number": "314-297-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUH",
        "first_name": "THOMAS",
        "middle_name": "HYUNG JUN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "90200000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamarra Lynn Subyantoro, APN
• Eric Thomas Sudholt, D.M.D.
• Nicole Marie Sudholt, D.M.D.
• Daniel Jack Sudrzynski, DO
• Chasity C Suggs, PMHNP-BC
• Stephanie Ann Sullivan, D.N.P., C.R.N.A.
• Fletcher Summa, MD
• Chrissa Manyetta Summers, CRNA
• Shauna Summers
• Summit Family Therapy PLLC

• Student in an Organized Health Care Education/Training Program in Peoria, IL
• Providers in Peoria, IL by specialty
• Student in an Organized Health Care Education/Training Program in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.