Individual
MR. DODI SUHARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1304 FRANKLIN AVE, NORMAL, IL 61761
(309) 454-1400
Mailing address
2151 BOULDER DR, NORMAL, IL 61761-9601
(909) 709-6164
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209011709
IL
367500000X
Certified Registered Nurse Anesthetist
60828812
WA
367500000X
Certified Registered Nurse Anesthetist
95000074
CA
Other
Enumeration date
11/06/2013
Last updated
05/29/2018
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