Individual
SUSAN BARCLAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 W 162ND ST, SOUTH HOLLAND, IL 60473-2003
(708) 730-2200
(708) 210-0621
Mailing address
100 W 162ND ST, SOUTH HOLLAND, IL 60473-2003
(708) 730-2200
(708) 210-0621
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036090785
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621679
BCBS OF IL
IL
Enumeration date
12/21/2005
Last updated
12/16/2021
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