Individual
SUSANNE RICHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
480 ELM PL, SUITE 104, HIGHLAND PARK, IL 60035-2538
(847) 234-4015
(847) 234-4015
Mailing address
480 ELM PL, SUITE 104, HIGHLAND PARK, IL 60035-2538
(847) 234-4015
(847) 234-4015
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
071006792
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04925695
BLUE SHIELD PROVIDER NUMB
IL
Enumeration date
12/19/2006
Last updated
04/19/2011
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