Individual
MS. SUSAN JEAN FAIRLEY-HOLBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2520 ELISHA AVE, ZION, IL 60099-2676
(847) 872-4888
(847) 872-5716
Mailing address
2520 ELISHA AVE, ZION, IL 60099-2676
(847) 872-6259
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209.007359
IL
Other
Enumeration date
12/10/2008
Last updated
02/15/2024
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