SUSAN TACCHERI M.D. NPI 1073546362

NPI Information

NPI: 1073546362
Provider Name: SUSAN TACCHERI, M.D.
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Individual

Specialization: Child & Adolescent Psychiatry

PECOS Registration: Yes

Address:
2600 OAKLAND AVE
ELKHART, IN
ZIP 46517
Phone: (574) 533-1234
Get Directions

Susan Taccheri, M.D. is a child and adolescent psychiatry psychiatry neurology in Elkhart, IN with 37 years of experience. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. Susan Taccheri, M.D. NPI is 1073546362. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: CHICAGO COLLEGE OF MEDICINE AND SURGERY
Graduation Year:1987

The provider's business location address is:

2600 OAKLAND AVE
ELKHART, IN
ZIP 46517-533
Phone: (574) 533-1234
Fax: (574) 537-2652

The NPI 1073546362 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/9/2006 and was last updated on 8/9/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0800X	Psychiatry & Neurology	Psychiatry	01054417A	INDIANA	No
2	2084P0802X	Psychiatry & Neurology	Addiction Psychiatry	01054417A	INDIANA	No
3	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	01054417A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000000202132	OTHER	INDIANA	ANTHEM
2	200344390	MEDICAID	INDIANA
3	226830U	MEDICARE PIN
4	P00184998	OTHER		RAILROAD MEDICARE PIN
5	F23759	MEDICARE UPIN	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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