Provider Demographics
NPI:1083369763
Name:REDDEN, SUSAN (CADC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:REDDEN
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3053 W FRANKLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-1000
Mailing Address - Country:US
Mailing Address - Phone:847-616-0660
Mailing Address - Fax:
Practice Address - Street 1:47 W POLK ST STE 250
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2765
Practice Address - Country:US
Practice Address - Phone:312-564-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)