Basic Information
| Provider Information | |||||||||
| NPI: | 1578531562 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROWE | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | A.T.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 735 S PARKSIDE DR | ||||||||
| Address2: | |||||||||
| City: | ROUND LAKE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600734260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6309283400 | ||||||||
| FaxNumber: | 6309283451 | ||||||||
| Practice Location | |||||||||
| Address1: | 625 ENTERPRISE DR | ||||||||
| Address2: | |||||||||
| City: | OAK BROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605238813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305756200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 146D00000X | IL | Y | Emergency Medical Service Providers | Personal Emergency Response Attendant |
No ID Information.