Individual
MRS. SUSAN MARIE LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
525 TYLER RD STE Q1, ST CHARLES, IL 60174-3360
(630) 444-0077
(630) 444-0078
Mailing address
3219 LARRABEE DR, GENEVA, IL 60134-4216
(630) 208-7141
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
056.002677
IL
Other
Enumeration date
01/04/2007
Last updated
01/07/2021
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