Individual
SUSAN WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
28650 BRAELOCH CT, LAKE BLUFF, IL 60044-3004
(847) 283-9852
Mailing address
28650 BRAELOCH CT, LAKE BLUFF, IL 60044-3004
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041327952
IL
Other
Enumeration date
02/16/2017
Last updated
02/16/2017
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