Healthcare Provider Details

I. General information

NPI: 1447746201
Provider Name (Legal Business Name): SUSAN O. OBMAN APN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSAN QUIGLEY RN

II. Dates (important events)

Enumeration Date: 07/05/2018
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 E BRUSH HILL RD
ELMHURST IL
60126-5658
US

IV. Provider business mailing address

1517 LAUREL OAKS DR
STREAMWOOD IL
60107-3318
US

V. Phone/Fax

Practice location:
  • Phone: 331-221-1000
  • Fax:
Mailing address:
  • Phone: 630-399-0723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277.002084
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number277002084
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: