Provider Demographics
NPI:1962936435
Name:CHERIAN, SUSY K (DNP,MSN, RN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SUSY
Middle Name:K
Last Name:CHERIAN
Suffix:
Gender:F
Credentials:DNP,MSN, RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 N BIRCHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-3502
Mailing Address - Country:US
Mailing Address - Phone:847-877-4756
Mailing Address - Fax:
Practice Address - Street 1:1333 BURR RIDGE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-6423
Practice Address - Country:US
Practice Address - Phone:630-832-1775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.015579363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily