Marilyn Ina Susman, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Practice address

1033 University PL
Evanston, IL 60201-3196

Phone

(847) 869-9300

Fax

(847) 869-4831

NPI assigned

Aug 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578576849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 UNIVERSITY PL",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013196",
            "telephone_number": "847-869-9300",
            "fax_number": "847-869-4831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 UNIVERSITY PL",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013196",
            "telephone_number": "847-869-9300",
            "fax_number": "847-869-4831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSMAN",
        "first_name": "MARILYN",
        "middle_name": "INA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS PROVIDER NUMBER",
            "identifier": "0001672831",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Surgical Associates, S.C.
• Tanya Surprenant
• Susan H Bowker, Professional Corp
• Mira Suseno, PHARMD
• Janet Sushinski, LCSW
• Judy H Sutherland, PHD
• Stephanie Nicole Sutherland, LSW
• Jonathan M Sutton, PHD
• Kia A Sutton, PHARMD
• Suzanne Greider Enterprises MD, PC

• Clinical Psychologist in Evanston, IL
• Providers in Evanston, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.