Individual
MS. SUSAN THOMA RAUCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
6000 BOND AVE, CENTREVILLE, IL 62207-2328
(618) 332-2083
(618) 337-6039
Mailing address
6000 BOND AVE, CENTREVILLE, IL 62207-2328
(618) 332-2083
(618) 337-6039
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209007010
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
277001773
IL
Other
Enumeration date
03/11/2008
Last updated
05/21/2025
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