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General NPI Number Information
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NPI Number | 1992731491
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Entity Type | Organization
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Legal Business Name | NEUROLOGIC CARE ASSOCIATES, P.C.
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3340 OAK PARK AVE SUITE 200
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City | BERWYN
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State | IL
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Zip | 60402-3420
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Country | US
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Telephone | 708-783-0222
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Fax | 708-783-0223
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Provider Business Mailing Address
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Address Line | 3340 OAK PARK AVE SUITE 200
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City | BERWYN
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State | IL
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Zip | 60402-3420
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Country | US
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Telephone | 708-783-0222
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Fax | 708-783-0223
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUSAN J SICOTTE
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Credential | M.D.
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Telephone | 708-783-0222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State | IL
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