Provider Demographics
NPI:1710001870
Name:REED, SUSAN (MSN, CSADC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:MSN, CSADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-1764
Mailing Address - Country:US
Mailing Address - Phone:847-421-3534
Mailing Address - Fax:847-251-5448
Practice Address - Street 1:690 OAK ST
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-2522
Practice Address - Country:US
Practice Address - Phone:847-475-1805
Practice Address - Fax:847-446-6957
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL428101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)