Susan Jean Brach
Individual provider Active NPI Registered Nurse First Assistant · Inverness, IL
NPI 1700288115 · NPPES record last updated Sep 17, 2014
Key facts
- NPI
- 1700288115
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse First Assistant 163WR0006X
- License
- 041.266305 (IL)
- Practice address
- 393 South Williams Road
Inverness, IL 60067-4559 - Phone
- (847) 477-0823
- NPI assigned
- Sep 17, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.266305 | IL | MD | Registered Nurse First Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse First Assistant | 163WR0006X | 041.266305 | IL | Yes |
Addresses
Primary practice location
393 South Williams Road
Inverness, IL 60067-4559
Mailing address
393 South Williams Road
Inverness, IL 60067-4559
Phone (847) 477-0823
Other providers in Inverness, IL
- Barrington Plastic Surgery, LTD
- Rebecca Benson
- Kesava Krishna Bhogaraju
- Jennifer Bochat
- Valerie A Bond
- Bravo Care of Inverness Inc
- Brennan Counseling, P.C.
- Thomas Ralph Bruno
- Shirley Butler
- Janine Cangialosi
All providers in Inverness, IL · Registered Nurse First Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.