MEDICARE: SUSAN CERZA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1083860357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN CERZA

Provider Business Mailing Address
First Line	:	307 COUNTRY CLUB DRIVE
Second Line	:
City	:	PROSPECT HEIGHTS
State	:	IL
Zip	:	60070-2571
Country	:	US
Telephone Number	:	224-622-5361
Fax Number	:

Provider Business Practice Location Address
First Line	:	307 COUNTRY CLUB DRIVE
Second Line	:
City	:	PROSPECT HEIGHTS
State	:	IL
Zip	:	60070-2571
Country	:	US
Telephone Number	:	224-622-5361
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2008
Last Update Date	:	08/16/2024

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Directions to “ SUSAN CERZA ” Practice Location

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