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Contact Information

SUSAN M PENNER
363 S RANDALL RD
ELGIN, IL60123
 Phone: 847-888-1555
 Fax: 847-888-2508
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for SUSAN M PENNER · (Female)

NPI # 1508088683
Status Active
Credentials
Entity Individual
Enumeration date 05/02/2007
Last updated 05/20/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • IL Other 4515286 BCBS
  • IL Other 0253870002 DMERC
  • IL Other 0253870001 MEDICARE SUPPLIER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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