Mira Suseno
Pharmacist
2650 Ridge Ave, Evanston
Illinois, 60201-1700
847-570-1021 Mira Suseno is a pharmacist in Evanston, Illinois. Patients can reach her at 2650 Ridge Ave, Evanston or contact her on 847-570-1021. Active license number of Mira Suseno is 051040649 for Pharmacist in Illinois.
Mira Suseno is
Complete Profile:
Mira Suseno speciality, credentials, practice address, contact phone number and fax are as below. Patients can call on the below given phone number for enquiries.
| Name: | Mira Suseno |
| Specialization: | Pharmacist |
| Credentials: | PHARMD |
| Gender: | Female |
| Location: | 2650 Ridge Ave, Evanston,
Illinois, 60201-1700 |
| Phone: | 847-570-1021 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of Mira Suseno are as mentioned below.
| NPI Number: | 1487523239 |
| NPI Enumeration Date: | 31 Oct, 2025 |
| NPI Last Update On: | 31 Oct, 2025 |
Medical Licenses:
Pharmacists can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mira Suseno are as mentioned below.
| Specialization | License Number | State | Status | |
| Pharmacist | 051040649 | Illinois | Primary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 1014 Highland Grove Ct N,
Buffalo Grove, Illinois |
| Zip: | 60089-7021 |
| Phone Number: | 847-570-1021 |
Patients can reach Mira Suseno at
2650 Ridge Ave, Evanston, Illinois or can
call on phone at 847-570-1021.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.