Mccolley, Susanna Antonia

Mccolley, Susanna Antonia is an individual health care provider with primary practice located at 2300 Childrens Plaza #43, Chgo IL 60614. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Pulmonology, which is considered as her primary health care specialty. Mccolley, Susanna Antonia can be contacted via phone (773) 880-8104.

Contact Information

Primary practice address
2300 Childrens Plaza #43 Chgo IL 60614
Phone: (773) 880-8104
Fax: (773) 880-6300
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Pulmonology 2080P0214X 36089384 Illinois

Profile Details

NPI number 1962470336
LBN Legal business name Mccolley, Susanna Antonia
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 10th, 2006
Last updated Sep 21st, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962470336 NPPES
Illinois MEDICAID 036089384

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