Provider Demographics
NPI:1861517906
Name:SUERTE, ELEUTERIO (MD)
Entity type:Individual
Prefix:
First Name:ELEUTERIO
Middle Name:
Last Name:SUERTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2744 N WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-2017
Mailing Address - Country:US
Mailing Address - Phone:773-772-7748
Mailing Address - Fax:
Practice Address - Street 1:2744 N WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-2017
Practice Address - Country:US
Practice Address - Phone:773-772-7748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1635426OtherBCBS
01635426OtherBCBS
IL036050653 1Medicaid