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:
Health care specialties
| Specialty | Code | License # | 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 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457323529 | NPPES |
| Illinois | Other | 1673585 | BLUE CROSS BLUE SHIELD |
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