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General NPI Number Information
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NPI Number | 1417008970
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Entity Type | Individual
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Provider Name | SUSAN RICKELS HARRIS AU.D., CCC-A
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 05/09/2024
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Provider Practice Location Address
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Address Line | 2604 DEMPSTER ST STE 501
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City | PARK RIDGE
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State | IL
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Zip | 60068-8429
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Country | US
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Telephone | 847-674-5585
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Fax |
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Provider Business Mailing Address
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Address Line | 8780 W GOLF RD SUITE 200
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City | NILES
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State | IL
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Zip | 60714-5602
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Country | US
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Telephone | 847-674-5585
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Fax | 847-824-7453
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 147.001326
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 1601000041
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License Number State | MI
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