Individual
DR. SUSAN MARIE HOLSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
427 E STATE ST, GENEVA, IL 60134-2337
(630) 208-7411
(630) 208-7466
Mailing address
427 E STATE ST, GENEVA, IL 60134-2337
(630) 208-7411
(630) 208-7466
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4507211
BC/BS PROVIDER #
IL
Enumeration date
08/01/2006
Last updated
07/08/2007
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