Provider Demographics
NPI:1285766535
Name:DR. AMY SUSZKO BROWN
Entity type:Organization
Organization Name:DR. AMY SUSZKO BROWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:SUSZKO
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:708-955-8070
Mailing Address - Street 1:9601 WEST 165TH STREET, SUITE 6
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467
Mailing Address - Country:US
Mailing Address - Phone:708-955-8070
Mailing Address - Fax:815-464-9737
Practice Address - Street 1:9601 WEST 165TH STREET, SUITE 6
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467
Practice Address - Country:US
Practice Address - Phone:708-955-8070
Practice Address - Fax:815-464-9737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005567103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty