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General NPI Number Information
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NPI Number | 1457482036
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Entity Type | Individual
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Provider Name | SUZANNE SCHNEEGAS-MAHONEY DDS
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 07/10/2015
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Provider Practice Location Address
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Address Line | 111 N. COUNTY FARM RD.
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City | WHEATON
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State | IL
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Zip | 60187-3988
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Country | US
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Telephone | 630-682-7979
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Fax | 630-462-9249
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Provider Business Mailing Address
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Address Line | 843 S KEARSAGE AVE
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City | ELMHURST
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State | IL
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Zip | 60126-4454
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Country | US
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Telephone | 630-833-8431
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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 | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 019020485
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License Number State | IL
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