Provider Demographics
NPI:1811914385
Name:MAJOR, SUSAN MARIE (MA CCC CLP)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MARIE
Last Name:MAJOR
Suffix:
Gender:F
Credentials:MA CCC CLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3N482 VACHEL LINDSAY STREET
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175
Mailing Address - Country:US
Mailing Address - Phone:630-901-8255
Mailing Address - Fax:630-485-6118
Practice Address - Street 1:3N482 VACHEL LINDSAY STREET
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175
Practice Address - Country:US
Practice Address - Phone:630-901-8225
Practice Address - Fax:630-485-6118
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146006010235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632733OtherBLUE CROSS BLUE SHIELD
IL01632733OtherBLUE CROSS BLUE SHIELD