Individual
MRS. SUSAN DENISE SEARS-LECLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3801 SPRING ST, MOUNT PLEASANT, WI 53405-1667
(262) 687-4011
Mailing address
2618 OLIVE ST, RACINE, WI 53403-2943
(630) 337-1367
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
085.002883
IL
363AM0700X
Medical Physician Assistant
Primary
5069-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
F400252938
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
10/02/2006
Last updated
01/12/2024
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