Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | IL | |
N | 103G00000X | Clinical Psychologist | 5507 | OH |
N | 103TC0700X | Clinical Psychologist | 5507 | OH |
NPI | 1003874173 |
---|---|
Provider Name | Dr. Susan Judith Soiferman |
First Address | Chicago, IL 60618-4950 |
Second Address | Chicago, IL 60614-2060 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 08/07/2007 |