O Dell, Susan Linda

O Dell, Susan Linda is an sole proprietor health care provider with primary practice located at 1422 W Thome Ave , Chicago IL 60660-1820. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. O Dell, Susan Linda can be contacted via phone (773) 262-7010.

Contact Information

Primary practice address
1422 W Thome Ave Chicago IL 60660-1820
Phone: (773) 262-7010
Fax: (773) 381-7889
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149 000735 Illinois

Profile Details

NPI number 1457323529
LBN Legal business name O Dell, Susan Linda
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 3rd, 2006
Last updated Jul 8th, 2007 - about 18 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 1457323529 NPPES
Illinois Other 1673585 BLUE CROSS BLUE SHIELD

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