Provider Demographics
NPI:1407015852
Name:RHEE, SUSAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:M
Last Name:RHEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 N WAUKEGAN RD
Mailing Address - Street 2:ABBVIE, R4NE AP34-1
Mailing Address - City:NORTH CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60064-1802
Mailing Address - Country:US
Mailing Address - Phone:847-937-1580
Mailing Address - Fax:
Practice Address - Street 1:1 N WAUKEGAN RD
Practice Address - Street 2:ABBVIE, R4NE AP34-1
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064-1802
Practice Address - Country:US
Practice Address - Phone:847-937-1580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252866-1207R00000X
MDD74419207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD055781100Medicaid
MD242655YXUMedicare PIN