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General NPI Number Information
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NPI Number | 1245383066
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Entity Type | Individual
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Provider Name | SUSAN WEXLER N.P.
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Gender | Female
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 12/07/2009
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Provider Practice Location Address
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Address Line | 215 REMINGTON BLVD. SUITE B
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City | BOLINGBROOK
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State | IL
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Zip | 60440
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Country | US
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Telephone | 630-226-5300
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Fax | 630-226-5308
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Provider Business Mailing Address
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Address Line | 215 REMINGTON BLVD SUITE B
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City | BOLINGBROOK
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State | IL
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Zip | 60440-3656
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Country | US
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Telephone | 630-226-5300
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Fax | 630-226-5308
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 209 003233
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License Number State | IL
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