Provider Demographics
NPI:1720434772
Name:SPIELMAN, SUSAN (APN)
Entity Type:Individual
Prefix:MISS
First Name:SUSAN
Middle Name:
Last Name:SPIELMAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 W HARRISON ST STE 207
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3988
Mailing Address - Country:US
Mailing Address - Phone:312-942-5861
Mailing Address - Fax:816-221-2335
Practice Address - Street 1:1725 W HARRISON ST STE 207
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3988
Practice Address - Country:US
Practice Address - Phone:312-942-5861
Practice Address - Fax:816-221-2335
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019028553363LA2100X
IL209.013962363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care