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Individual

SUSAN E. NIEZGODA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN,CNS,PMHNP

Contact information

Practice address
734 W 47TH ST, CHICAGO, IL 60609-4411
(773) 536-8400
(773) 536-2406
Mailing address
UIC COLLEGE OF NURSING (MC802) 845 S. DAMEN AVE., PMA DEPARTMENT, 9TH FLOOR, CHICAGO, IL 60612-7350
(312) 996-7996
(312) 996-7725

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0040030710
BC/BS
IL
Enumeration date
10/16/2006
Last updated
07/08/2007
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