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Individual

DR. SUSAN E CRAWFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
TERESA CAMP, NORTHWESTERN FACULTY FDN, PROV ENROLLMENT, 680 LAKESHORE DRIVE, SUITE #1000, CHICAGO, IL 60611
(314) 977-4559
Mailing address
TERESA CAMP, NORTHWESTERN FACULTY FDN, PROV ENROLLMENT, 680 LAKESHORE DRIVE, SUITE #1000, CHICAGO, IL 60611
(314) 977-4559

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036079326
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036079326
IL
Enumeration date
07/29/2005
Last updated
09/26/2012
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