White, Susan A
White, Susan A is an sole proprietor health care provider with primary practice located at 800 Main St Ste 11 Lower Level, Antioch IL 60002-1542. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. White, Susan A can be contacted via phone (224) 577-5022.Contact Information
Primary practice address
800 Main St Ste 11 Lower Level
Antioch IL 60002-1542
Phone: (224) 577-5022
Fax: (847) 395-9551
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 149-011526 | Illinois |
Profile Details
| NPI number | 1508919812 |
|---|---|
| LBN Legal business name | White, Susan A |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 19th, 2007 |
| Last updated | May 22nd, 2015 - about 9 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 | 1508919812 | NPPES |
| Illinois | Other | 11722321 | CAQH |
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