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General NPI Number Information
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NPI Number | 1356468656
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Entity Type | Individual
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Provider Name | SUSAN T MITCHELL MD
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Gender | Female
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 1319 BUTTERFIELD RD STE 506
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-5601
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Country | US
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Telephone | 630-320-6703
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 735044
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City | CHICAGO
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State | IL
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Zip | 60673-5044
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Country | US
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Telephone | 800-326-2250
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Fax |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4827-320
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 01086121A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036117849
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 036117849
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License Number State | IL
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