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Individual

EARL JUSTIN SUICO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
901 BIESTERFIELD RD STE 308, ELK GROVE VILLAGE, IL 60007-7324
(847) 437-9889
Mailing address
1461 W SUMMERDALE AVE APT 1B, CHICAGO, IL 60640-2149
(331) 645-0936

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.006852
IL

Other

Enumeration date
09/23/2025
Last updated
09/23/2025
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