Individual
SUSAN JAYNE OPACIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
333 MADISON ST, JOLIET, IL 60435-8200
(815) 725-7133
Mailing address
1542 PORTSMOUTH LAKE DR, BRANDON, FL 33511-1832
(708) 606-0887
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041391527
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209019315
IL
Other
Enumeration date
09/26/2018
Last updated
08/07/2019
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