Doctor Name: | MARY SUSAN SANDRIK |
NPI Number: | 1154616928 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSN, RN, CWOCN |
License Number: | 309.000463 |
Business Practice Address: | 1500 South California Avenue Chicago, IL - 60608 |
Business Phone Number: | 7735422000 |
Business Fax Number: | 7732575205 |
Mailing Address: | 2248 Grove Ave, BERWYN |
State: | IL |
Postal Code: | 604022201 |
Phone Number: | 7087887340 |
Fax Number: | |
NPI Enumeration Date: | 06/09/2011 |
NPI Last Update Date: | 06/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364S00000X |
License Number: | 309.000463 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. |