Provider Demographics
NPI:1730244195
Name:PACHTMAN, SUZANNE (DPT, MS)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:PACHTMAN
Suffix:
Gender:F
Credentials:DPT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 ELIZABETH LN
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-3159
Mailing Address - Country:US
Mailing Address - Phone:847-849-0476
Mailing Address - Fax:610-643-5087
Practice Address - Street 1:1404 ELIZABETH LN
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-3159
Practice Address - Country:US
Practice Address - Phone:847-849-0476
Practice Address - Fax:610-643-5087
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.016678174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist