Individual
DR. SUSAN MARIE BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2302 W NORTH AVE STE 1E, CHICAGO, IL 60647-9755
(312) 806-2140
Mailing address
2065 N KEDZIE AVE APT 326, CHICAGO, IL 60647-3858
(312) 806-2140
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071009612
IL
Other
Enumeration date
09/14/2017
Last updated
09/14/2017
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