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NPI Code Detail

MEDICARE: DR. SUSAN BURATTO MD

MEDICARE: DR. SUSAN BURATTO MD
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
12084P0800XPsychiatry Physician036123313IL

General Provider Information

NPI Number : 1174788095
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN BURATTO MD
Provider Business Mailing Address
First Line : 4101 N RAVENSWOOD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2193
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4101 N RAVENSWOOD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2193
Country : US
Telephone Number : 773-572-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2008
Last Update Date : 11/10/2020

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Directions to “ DR. SUSAN BURATTO MD” Practice Location

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