MEDICARE: MRS. SUSAN OBMAN FNP-C

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	363L00000X	Nurse Practitioner	209017687	IL
2	363LF0000X	Family Nurse Practitioner	277.002084	IL

General Provider Information

NPI Number	:	1447746201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN OBMAN FNP-C

Provider Business Mailing Address
First Line	:	1517 LAUREL OAKS DR
Second Line	:
City	:	STREAMWOOD
State	:	IL
Zip	:	60107-3318
Country	:	US
Telephone Number	:	630-399-0723
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 E BRUSH HILL RD
Second Line	:
City	:	ELMHURST
State	:	IL
Zip	:	60126-5658
Country	:	US
Telephone Number	:	331-221-1000
Fax Number	:

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

Provider Enumeration Date	:	07/05/2018
Last Update Date	:	01/14/2026

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