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Individual

SUSAN M PHELAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
299 N MAPLE AVE, WOOD DALE, IL 60191-1512
(773) 519-0896
Mailing address
1010 N HOOKER ST, CHICAGO, IL 60642-4549
(312) 943-3600
(866) 410-9192

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041305029
IL
163WH0200X
Home Health Registered Nurse
041305029
IL

Other

Enumeration date
09/08/2014
Last updated
09/08/2014
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