Provider Demographics
NPI:1386725216
Name:SUH, DUCKIN (DC)
Entity type:Individual
Prefix:DR
First Name:DUCKIN
Middle Name:
Last Name:SUH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W GOLF RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-4004
Mailing Address - Country:US
Mailing Address - Phone:847-364-2424
Mailing Address - Fax:847-364-2423
Practice Address - Street 1:1600 W GOLF RD
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-4004
Practice Address - Country:US
Practice Address - Phone:847-364-2424
Practice Address - Fax:847-364-2423
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007998111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL215980Medicare ID - Type Unspecified