V Susarla Mdsc

NPI #1952583783 in Elgin, Illinois

Provider Information

NPI Number: 1952583783
Entity Type: Organization
Organization Name: V Susarla Mdsc
Primary Specialty: Internal Medicine
Enumeration Date: Dec 4, 2007
Last Updated: Dec 21, 2007

Practice Location

Address: 860 SUMMIT ST
Address 2: SUITE 123
City: Elgin
State: Illinois
ZIP Code: 60120-5145
Phone: (847) 741-0026

Authorized Official

Name: VISWANATHAM SUSARLA, MD
Title: PHYSICIAN
Phone: (847) 741-0026

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Internal Medicine	207R00000X	Primary

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