Healthcare Provider Details

I. General information

NPI: 1154439099
Provider Name (Legal Business Name): SUSAN C DENEY APN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 WAUKEGAN RD SUITE 1200
LAKE BLUFF IL
60044-3012
US

IV. Provider business mailing address

101 WAUKEGAN RD SUITE 1200
LAKE BLUFF IL
60044-3012
US

V. Phone/Fax

Practice location:
  • Phone: 847-295-8500
  • Fax: 847-295-8501
Mailing address:
  • Phone: 847-295-8500
  • Fax: 847-295-8501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209002813
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209-002813
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: