Individual
KAYLYNN SUSTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1450 E DIVISION ST, DIAMOND, IL 60416-6050
(815) 634-3500
(815) 705-1718
Mailing address
725 SCHOOL ST STE A, MORRIS, IL 60450-1207
(815) 941-9124
(815) 941-4363
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209015024
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209.015024
LICENSE
ID
Enumeration date
10/25/2016
Last updated
04/06/2020
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