Individual
DR. SUSIE MARIA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
304 RANDALL RD, GENEVA, IL 60134-4200
(630) 232-0610
(630) 232-0675
Mailing address
304 RANDALL RD, GENEVA, IL 60134-4200
(630) 232-0610
(630) 232-0675
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
32474
WI
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
036083093
IL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
036083093
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036083093
MEDICAID PTAN
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
F400174048
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
01/06/2012
Last updated
09/16/2025
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