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Individual

SUZANNE OLHA PARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
701 W NORTH AVE, MELROSE PARK, IL 60160-1612
(708) 681-7859
Mailing address
1121 LAKE COOK RD STE M, DEERFIELD, IL 60015-5234
(847) 945-4550

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041-336253
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209008274
IL

Other

Enumeration date
07/09/2010
Last updated
10/15/2018
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