Individual
MRS. SUSAN MARY WINSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4232 DEMPSTER ST, SKOKIE, IL 60076-2008
(847) 869-6610
(847) 869-7380
Mailing address
5205 N LONG AVE, CHICAGO, IL 60630-1437
(773) 427-5948
(847) 869-7380
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SW09340602P
EI CREDENTIAL
IL
Enumeration date
04/02/2007
Last updated
07/08/2007
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