Provider Demographics
NPI:1942368782
Name:WEBER, SUSAN E (APN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:WEBER
Suffix:
Gender:F
Credentials:APN
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Mailing Address - Street 1:800 BIESTERFIELD RD
Mailing Address - Street 2:SUITE 510
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3361
Mailing Address - Country:US
Mailing Address - Phone:847-981-3660
Mailing Address - Fax:847-956-5108
Practice Address - Street 1:100 SPALDING DR
Practice Address - Street 2:SUITE 200
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6550
Practice Address - Country:US
Practice Address - Phone:630-355-8776
Practice Address - Fax:630-355-7445
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2014-11-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL209005237363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400128252Medicare PIN
ILQ73598Medicare UPIN
ILF400128254Medicare PIN