Healthcare Provider Details

I. General information

NPI: 1366578932
Provider Name (Legal Business Name): SUSAN ELIZABETH PAUNA M.S., L.C.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 11/03/2024
Certification Date: 11/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 IROQUOIS AVE STE 500A
NAPERVILLE IL
60563-8598
US

IV. Provider business mailing address

1240 IROQUOIS AVE STE 500A
NAPERVILLE IL
60563-8598
US

V. Phone/Fax

Practice location:
  • Phone: 630-865-9975
  • Fax: 630-345-5444
Mailing address:
  • Phone: 630-865-9975
  • Fax: 630-345-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.004475
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.007810
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: