Suzy Azalea

Dentist · Bolingbrook, IL

Individual Active NPI

NPI number 1063849776

Practice location

761 E Boughton Rd
Bolingbrook, IL 60440-2281
Phone
(630) 739-9430

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NPI record

NPI
1063849776
Entity type
Individual (Type 1)
Enumeration date
September 26, 2013
Last updated
September 26, 2013
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 019024791 IL

About Suzy Azalea

Suzy Azalea is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 761 E Boughton Rd, Bolingbrook, IL 60440-2281. The NPI number 1063849776 was assigned on September 26, 2013 and the record was last updated on September 26, 2013.

Suzy Azalea lists a license in the registry: #019024791 (IL) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Suzy Azalea?

The NPI number is 1063849776.

What is the phone number of Suzy Azalea?

The phone number listed for the practice location is (630) 739-9430.

Where is Suzy Azalea located?

761 E Boughton Rd, Bolingbrook, IL 60440-2281.

What is the taxonomy code for Suzy Azalea?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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