Provider Demographics
NPI:1598125940
Name:TADDEUCCI, SUZANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:
Last Name:TADDEUCCI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:0N416 LAKE DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-3015
Mailing Address - Country:US
Mailing Address - Phone:630-347-7907
Mailing Address - Fax:
Practice Address - Street 1:55 E LOOP RD STE 203
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-1938
Practice Address - Country:US
Practice Address - Phone:630-653-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-27
Last Update Date:2016-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490031821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical