Provider Demographics
NPI:1275740870
Name:SARTORE, SUSANNE MARIE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:SUSANNE
Middle Name:MARIE
Last Name:SARTORE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 N HOUGH ST
Mailing Address - Street 2:#205
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-3075
Mailing Address - Country:US
Mailing Address - Phone:847-713-2465
Mailing Address - Fax:
Practice Address - Street 1:2200 W HIGGINS RD
Practice Address - Street 2:SUITE 105
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60195-2428
Practice Address - Country:US
Practice Address - Phone:847-310-8450
Practice Address - Fax:847-310-8442
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1637051OtherBCBS PIN #