Provider Demographics
NPI:1447746201
Name:OBMAN, SUSAN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:OBMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:QUIGLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1517 LAUREL OAKS DR
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-3318
Mailing Address - Country:US
Mailing Address - Phone:630-399-0723
Mailing Address - Fax:
Practice Address - Street 1:155 E BRUSH HILL RD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5658
Practice Address - Country:US
Practice Address - Phone:331-221-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209017687363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner