Provider Demographics
NPI:1841510518
Name:SUZUKI, SARAH A (LCSW, CADC)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:A
Last Name:SUZUKI
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N MICHIGAN AVE STE 704
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-3905
Mailing Address - Country:US
Mailing Address - Phone:312-715-8234
Mailing Address - Fax:844-611-0146
Practice Address - Street 1:333 N MICHIGAN AVE STE 704
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-3905
Practice Address - Country:US
Practice Address - Phone:312-715-8234
Practice Address - Fax:844-611-0146
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL28743101YA0400X
IL149.0149261041C0700X
IL248.0017111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL06102Medicare UPIN
IL06102Medicare PIN
IL06102OtherMEDICARE PTAN