Provider Demographics
NPI:1548063233
Name:SUKER, BOZICA (PT)
Entity type:Individual
Prefix:
First Name:BOZICA
Middle Name:
Last Name:SUKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 GLEN LN
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-5221
Mailing Address - Country:US
Mailing Address - Phone:630-991-7886
Mailing Address - Fax:
Practice Address - Street 1:614 GLEN LN
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-5221
Practice Address - Country:US
Practice Address - Phone:630-991-7886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-29
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.006612225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist