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NPI Code Detail

MEDICARE: DR. SUZANNE SCHNEEGAS-MAHONEY DDS

MEDICARE: DR. SUZANNE SCHNEEGAS-MAHONEY DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223D0001XPublic Health Dentistry019020485IL

General Provider Information

NPI Number : 1457482036
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUZANNE SCHNEEGAS-MAHONEY DDS
Provider Business Mailing Address
First Line : 843 S KEARSAGE AVE
Second Line :
City : ELMHURST
State : IL
Zip : 60126-4454
Country : US
Telephone Number : 630-833-8431
Fax Number :
Provider Business Practice Location Address
First Line : 111 N. COUNTY FARM RD.
Second Line :
City : WHEATON
State : IL
Zip : 60187-3988
Country : US
Telephone Number : 630-682-7979
Fax Number : 630-462-9249
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2007
Last Update Date : 07/10/2015

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