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Individual
SUSAN IGNATIUS
Active
Individual
SUSAN IGNATIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036090377
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036090377
—
IL
01
—
920540
MEDICARE GROUP PTAN
IL
01
—
F400137406
MEDICARE INDIVIDUAL PTAN
IL
Enumeration date
09/08/2006
Last updated
10/23/2014
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