Walsh, Susan Marie

Walsh, Susan Marie is an individual health care provider with primary practice located at 2160 S First Ave (Fahey Bldg., Rm. 222), Maywood IL 60153. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Walsh, Susan Marie can be contacted via phone (708) 216-3750.

Contact Information

Primary practice address
2160 S First Ave (Fahey Bldg., Rm. 222) Maywood IL 60153
Phone: (708) 216-3750
Fax: (708) 216-6840
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 71005168 Illinois
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071005168 Illinois

Profile Details

NPI number 1407823206
LBN Legal business name Walsh, Susan Marie
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2006
Last updated May 5th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407823206 NPPES
Illinois MEDICAID 71005168

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