Individual
DR. SUSAN SCHABERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2601 W MAIN ST, CARBONDALE, IL 62901-1031
(618) 549-5361
(618) 549-5128
Mailing address
2601 W MAIN ST, CARBONDALE, IL 62901-1031
(618) 549-5361
(618) 549-5128
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036110448
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
089145
HAMP INS. PROVIDER #
IL
01
—
213100
GROUP HEALTH PLAN PROVIDE
IL
05
—
36110448
—
IL
01
—
629880
HEALTHLINK PROVIDER NUMBE
IL
01
—
P00088934
RAILROAD MEDICARE NUMBER
IL
Enumeration date
03/11/2006
Last updated
07/09/2007
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