Provider Demographics
NPI:1043356363
Name:NAY, SUSAN MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MARIE
Last Name:NAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2679 COLLEGE HILL CIR
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5752
Mailing Address - Country:US
Mailing Address - Phone:847-925-0327
Mailing Address - Fax:
Practice Address - Street 1:1920 THOREAU DR N
Practice Address - Street 2:SUITE 151
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4176
Practice Address - Country:US
Practice Address - Phone:847-303-1880
Practice Address - Fax:847-303-1881
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.004926103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist