| Doctor Name: | MRS. MARIE SUZANNE DOCTOR |
| NPI Number: | 1033424346 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, LPC, CADC |
| License Number: | 178.005122 |
| Business Practice Address: | 15127 S. 73rd Ave Suite G Orland Park, IL - 604624398 |
| Business Phone Number: | 7088455500 |
| Business Fax Number: | 7088455505 |
| Mailing Address: | 15127 S 73rd Ave Ste G, ORLAND PARK |
| State: | IL |
| Postal Code: | 604623425 |
| Phone Number: | 7088455500 |
| Fax Number: | 7088455505 |
| NPI Enumeration Date: | 08/11/2010 |
| NPI Last Update Date: | 08/11/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 178.005122 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |