Individual
SUZANNE MARIE ANDERER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8206 W WOODVALE RD, FRANKFORT, IL 60423-9171
(815) 469-0050
(815) 469-0050
Mailing address
8206 W WOODVALE RD, FRANKFORT, IL 60423-9171
(815) 469-0050
(815) 469-0050
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
220.000021
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220.000021
ELECTROLOGIST LICENSE NUMBER
IL
Enumeration date
07/11/2016
Last updated
07/11/2016
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