Susanne Tidow-Kebritchi
Ophthalmologist
2160 S 1st Ave (9608 Roberts Rd, Hickory Hills, Il. 60457)
Maywood
, Illinois 60153
Susanne Tidow-Kebritchi
Ophthalmologist
2160 S 1st Ave (9608 Roberts Rd, Hickory Hills, Il. 60457)
Maywood
, Illinois 60153
(708) 233-5348
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About
Features
Specialties
- Ophthalmologist
Languages spoken
- English
Location
First Address
- Susanne Tidow-Kebritchi
- 2160 S 1st Ave (9608 Roberts Rd, Hickory Hills, Il. 60457)
- Maywood, IL
- Zip : 60153
- Fax : (708) 233-5348
- Phone : (708) 233-5333
Second Address
- Susanne Tidow-Kebritchi
- 2160 S 1st Ave (9608 Roberts Rd, Hickory Hills, Il. 60457)
- Maywood, IL
- Zip : 60153
- Fax : (708) 233-5348
- Phone : (708) 233-5333
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207W00000X | Ophthalmologist | 36108445 | IL |
National Provider Identifier
| NPI | 1023082153 |
|---|---|
| Provider Name | Susanne Tidow-Kebritchi |
| First Address | Maywood, IL 60153 |
| Second Address | Maywood, IL 60153 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/02/2006 |
| Last Update Date | 05/03/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 36108445 | (05) | IL |
| H96995 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.