Provider Demographics
NPI:1124300520
Name:HATFIELD, SUZAN (APN)
Entity type:Individual
Prefix:MRS
First Name:SUZAN
Middle Name:
Last Name:HATFIELD
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2614 W JEFFERSON ST
Mailing Address - Street 2:SUITE # 110
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6433
Mailing Address - Country:US
Mailing Address - Phone:815-725-1355
Mailing Address - Fax:
Practice Address - Street 1:100 SPALDING DR
Practice Address - Street 2:SUITE # 110
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6550
Practice Address - Country:US
Practice Address - Phone:630-369-1501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.009013363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health