Provider Demographics
NPI:1457482036
Name:SCHNEEGAS-MAHONEY, SUZANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:SCHNEEGAS-MAHONEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 S KEARSAGE AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-4454
Mailing Address - Country:US
Mailing Address - Phone:630-833-8431
Mailing Address - Fax:
Practice Address - Street 1:111 N. COUNTY FARM RD.
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-3988
Practice Address - Country:US
Practice Address - Phone:630-682-7979
Practice Address - Fax:630-462-9249
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190204851223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health