Individual
SUZAN AL GHARAIBEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
751 N RUTLEDGE ST, RM 2300, SPRINGFIELD, IL 62702
(217) 545-3821
(217) 545-4735
Mailing address
701 N 1ST ST, PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-7578
(217) 545-1884
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
036-113428
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036113428
—
IL
Enumeration date
05/15/2007
Last updated
07/06/2018
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