Provider Demographics
NPI:1063840270
Name:WOODEN, SUSAN E (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:E
Last Name:WOODEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 CAPITAL DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-6144
Mailing Address - Country:US
Mailing Address - Phone:847-513-0077
Mailing Address - Fax:
Practice Address - Street 1:2323 CAPITAL DR
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-6144
Practice Address - Country:US
Practice Address - Phone:847-513-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-24
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.297051183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist