Individual
DR. SUSAN J ANDERSON-NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2015 N MAIN ST, WHEATON, IL 60187-3152
(630) 668-8250
(630) 668-8916
Mailing address
2015 N MAIN ST, WHEATON, IL 60187-3152
(630) 668-8250
(630) 668-8916
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
36-079057
IL
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
036079057
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036079057
—
IL
01
—
180012234
RR MEDICARE
IL
Enumeration date
10/05/2005
Last updated
08/21/2024
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