Provider Demographics
NPI:1154439099
Name:DENEY, SUSAN C (APN)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:C
Last Name:DENEY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:101 WAUKEGAN RD
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:LAKE BLUFF
Mailing Address - State:IL
Mailing Address - Zip Code:60044-3012
Mailing Address - Country:US
Mailing Address - Phone:847-295-8500
Mailing Address - Fax:847-295-8501
Practice Address - Street 1:101 WAUKEGAN RD
Practice Address - Street 2:SUITE 1200
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-3012
Practice Address - Country:US
Practice Address - Phone:847-295-8500
Practice Address - Fax:847-295-8501
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209-002813363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP75100Medicare UPIN