NICHOLE SUZANNE SUCKOW

EFFINGHAM, IL
NPI1902892318
Former NameNICHOLE SUZANNE MYERS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  085-002146)
Enumeration Date2005-09-21
Last Update Date2011-11-02
Business Address
-- NICHOLE SUZANNE SUCKOW PA-C
912 N HENRIETTA ST
EFFINGHAM, IL 62401-1788
Phone number: 217-342-3337
Mailing Address
-- NICHOLE SUZANNE SUCKOW PA-C
PO BOX 784
EFFINGHAM, IL 62401-0784
Phone number: 217-342-3337
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