Provider Demographics
NPI:1982709705
Name:HAMADA, SUSAN E (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:HAMADA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 MCDONALD RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-3323
Mailing Address - Country:US
Mailing Address - Phone:847-468-1206
Mailing Address - Fax:847-468-1507
Practice Address - Street 1:2000 MCDONALD RD
Practice Address - Street 2:SUITE 220
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177-3323
Practice Address - Country:US
Practice Address - Phone:847-468-1206
Practice Address - Fax:847-468-1507
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036087651207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04532380OtherBCBS