Provider Demographics
NPI:1578787701
Name:ROSENFELD, SUZANNE LYNNE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:LYNNE
Last Name:ROSENFELD
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 1:180 N MICHIGAN AVE STE 2200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7477
Mailing Address - Country:US
Mailing Address - Phone:312-658-0320
Mailing Address - Fax:
Practice Address - Street 1:910 N LAKE SHORE DR
Practice Address - Street 2:APT 1919
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-1540
Practice Address - Country:US
Practice Address - Phone:312-202-1105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0835062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry