Provider Demographics
NPI:1205024023
Name:SHERMAN, SUSAN LEEDS (MS)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:LEEDS
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8780 W GOLF RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-5602
Mailing Address - Country:US
Mailing Address - Phone:847-824-4390
Mailing Address - Fax:
Practice Address - Street 1:8780 W GOLF RD
Practice Address - Street 2:SUITE 200
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-5602
Practice Address - Country:US
Practice Address - Phone:847-824-4390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter