Individual
DR. SUSANNA COERS BYRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9169
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9169
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036128915
IL
207L00000X
Anesthesiology Physician
125-056389
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125-056389
ILLINOIS TEMPORARY LISCENSE
IL
Enumeration date
06/02/2009
Last updated
04/30/2021
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