Tidow-Kebritchi, Susanne

Tidow-Kebritchi, Susanne is an individual health care provider with primary practice located at 2160 S 1St Ave (9608 Roberts Rd, Hickory Hills, Il. 60457), Maywood IL 60153. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Tidow-Kebritchi, Susanne can be contacted via phone (708) 233-5333.

Contact Information

Primary practice address
2160 S 1St Ave (9608 Roberts Rd, Hickory Hills, Il. 60457) Maywood IL 60153
Phone: (708) 233-5333
Fax: (708) 233-5348
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 36108445 Illinois

Profile Details

NPI number 1023082153
LBN Legal business name Tidow-Kebritchi, Susanne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Mar 5th, 2010 - about 14 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 1023082153 NPPES
Illinois MEDICAID 36108445

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