Doctor Name: | SUSAN AGRUSS |
NPI Number: | 1073777082 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW, CADC |
License Number: | 28335 |
Business Practice Address: | 2625 Butterfield Rd Suite 101n Oak Brook, IL - 605231234 |
Business Phone Number: | 6305860900 |
Business Fax Number: | 6305869990 |
Mailing Address: | 2625 Butterfield Rd, Suite 101n OAK BROOK |
State: | IL |
Postal Code: | 605231234 |
Phone Number: | 6305860900 |
Fax Number: | 6305869990 |
NPI Enumeration Date: | 07/18/2008 |
NPI Last Update Date: | 05/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 28335 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |