Provider Demographics
NPI:1871200980
Name:SUSLOVAS, DORINA (NP)
Entity type:Individual
Prefix:
First Name:DORINA
Middle Name:
Last Name:SUSLOVAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DORINA
Other - Middle Name:
Other - Last Name:MURARIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:7300 W COLLEGE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1181
Mailing Address - Country:US
Mailing Address - Phone:312-659-9698
Mailing Address - Fax:
Practice Address - Street 1:7300 W COLLEGE DR STE 102
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1181
Practice Address - Country:US
Practice Address - Phone:312-659-9698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.026039363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner