Individual
SUSAN G VIERLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
130 S MAIN ST, SUITE 303, LOMBARD, IL 60148-2670
(630) 424-9877
(630) 424-9878
Mailing address
172 CLINTON AVE, ELMHURST, IL 60126-2907
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036091886
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031600193
BLUE SHIELD
IL
05
—
036091886
—
IL
01
—
K1444
MEDICARE PROVIDER NUMBER
IL
01
—
P00251102
RAILROAD MEDICARE
IL
Enumeration date
01/12/2006
Last updated
12/21/2021
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