Individual
DR. SUSAN RICKELS HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AU.D., CCC-A
Contact information
Practice address
2604 DEMPSTER ST STE 501, PARK RIDGE, IL 60068-8429
(847) 674-5585
Mailing address
8780 W GOLF RD, SUITE 200, NILES, IL 60714-5602
(847) 674-5585
(847) 824-7453
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147.001326
IL
231H00000X
Audiologist
1601000041
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P20170006
MEDICARE PTAN
—
Enumeration date
01/12/2007
Last updated
05/09/2024
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