| Doctor Name: | MS. SUSAN ELIZABETH PRUST |
| NPI Number: | 1982765137 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT DIP MDT |
| License Number: | |
| Business Practice Address: | 2 East Rollins Rd Suite 106 Round Lake Beach, IL - 60073 |
| Business Phone Number: | 8477402296 |
| Business Fax Number: | 8477400125 |
| Mailing Address: | 6727 Nantucket Ct, GURNEE |
| State: | IL |
| Postal Code: | 600314015 |
| Phone Number: | 8478551803 |
| Fax Number: | |
| NPI Enumeration Date: | 12/12/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |