Individual
DR. SUZANNE DONICK SIEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 N WESTMORELAND RD, LAKE FOREST, IL 60045-1658
(847) 535-6150
(847) 535-7801
Mailing address
1000 N WESTMORELAND RD, LAKE FOREST, IL 60045-1658
(847) 535-6150
(847) 535-7801
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-093476
IL
207P00000X
Emergency Medicine Physician
37868-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278926842
—
IL
05
—
32328700
—
WI
01
—
930050422
MEDICARE RAILROAD
WI
01
—
930062811
MEDICARE RAILROAD
IL
01
—
930068395
MEDICARE RAILROAD
WI
Enumeration date
06/03/2006
Last updated
09/19/2022
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