Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 019020485 | IL |
NPI | 1457482036 |
---|---|
Provider Name | Dr. Suzanne Schneegas-Mahoney |
First Address | Elmhurst, IL 60126-4454 |
Second Address | Wheaton, IL 60187-3988 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 10/07/2015 |