Individual
LADOUGLAS J SUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 W CENTRAL RD DEPT OF, ARLINGTON HEIGHTS, IL 60005-2349
(847) 570-2760
Mailing address
2650 RIDGE AVE # 1223, EVANSTON, IL 60201-1700
(847) 733-5315
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01080262A
IN
207L00000X
Anesthesiology Physician
036.143816
IL
207L00000X
Anesthesiology Physician
Primary
036143816
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
01080262A
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
036143816
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
095200143
MEDICARE PTAN
IN
05
—
300076213
—
IN
Enumeration date
07/25/2012
Last updated
11/08/2024
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