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General NPI Number Information
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NPI Number | 1679752596
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Entity Type | Organization
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Legal Business Name | SUSAN E. HAMADA, M.D. LTD.
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 2197 BLACKBERRY DR
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City | GENEVA
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State | IL
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Zip | 60134-4713
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Country | US
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Telephone | 630-232-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 42W510 HIDDEN SPRINGS DR
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City | ST CHARLES
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State | IL
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Zip | 60175-8247
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Country | US
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Telephone | 630-587-6629
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUSAN E. HAMADA
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Credential | M.D.
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Telephone | 630-587-6629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | IL
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