Individual
SUSI SANTOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1005 ALEXANDER CT UNIT D, CARY, IL 60013-1891
(312) 929-6713
Mailing address
192 DUNDEE RD, INVERNESS, IL 60010-5254
(312) 929-6713
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-46873
IL
Other
Enumeration date
01/18/2021
Last updated
09/10/2025
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