Provider Demographics
NPI:1639242035
Name:HOWEY, SUSAN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MARIE
Last Name:HOWEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:MARIE
Other - Last Name:KRISTENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10350 HALIGUS RD STE 120
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-9526
Mailing Address - Country:US
Mailing Address - Phone:815-356-2323
Mailing Address - Fax:847-802-7201
Practice Address - Street 1:10350 HALIGUS RD STE 120
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-9526
Practice Address - Country:US
Practice Address - Phone:815-356-2323
Practice Address - Fax:847-802-7201
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10411530-1205207V00000X
IL036-103272207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036103272 2Medicaid
IL214660 K12841Medicare ID - Type Unspecified
H70507Medicare UPIN