Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 19014142 | IL |
N | 1223E0200X | Endodontist | IL |
NPI | 1104961341 |
---|---|
Provider Name | Dr. Suzanne B Erskine |
First Address | Wheaton, IL 60187-5589 |
Second Address | Wheaton, IL 60187-5589 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 08/07/2007 |