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Individual

DR. SUSAN MARIE RADTKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
8581 DOLFOR CV, BURR RIDGE, IL 60527-8350
(630) 740-7983
(630) 323-5304
Mailing address
8581 DOLFOR CV, BURR RIDGE, IL 60527-8350
(630) 740-7983
(630) 323-5304

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071006342
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-0637807
FEDERAL TAX ID
IL
01
01632203
BLUE CROSS/BLUE SHIELD ID
IL
Enumeration date
07/19/2006
Last updated
11/20/2025
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