Doctor Name: | MS. SUSAN KAYE O'MARA |
NPI Number: | 1043553720 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 209.000384 |
Business Practice Address: | 1775 Dempster St Park Ridge, IL - 600681143 |
Business Phone Number: | 8477237939 |
Business Fax Number: | 8477232272 |
Mailing Address: | 1775 Dempster St, PARK RIDGE |
State: | IL |
Postal Code: | 600681143 |
Phone Number: | 8477237939 |
Fax Number: | 8477232272 |
NPI Enumeration Date: | 04/01/2013 |
NPI Last Update Date: | 04/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SA2100X |
License Number: | 209.000384 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |