Provider Demographics
NPI:1851574636
Name:SUSAN M. FELBER, M.D., S.C.
Entity Type:Organization
Organization Name:SUSAN M. FELBER, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:FELBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-654-2229
Mailing Address - Street 1:545 PLAINFIELD RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7600
Mailing Address - Country:US
Mailing Address - Phone:630-654-2229
Mailing Address - Fax:630-655-3270
Practice Address - Street 1:545 PLAINFIELD RD
Practice Address - Street 2:SUITE C
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-7600
Practice Address - Country:US
Practice Address - Phone:630-654-2229
Practice Address - Fax:630-655-3270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036074248207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE21586Medicare UPIN