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1043085871
RICHARD HENRY LOGAN
OAK PARK, IL
NPI
1043085871
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: IL 209.028575)
Enumeration Date
2023-11-21
Last Update Date
2024-05-15
Business Address
RICHARD HENRY LOGAN PMHNP-BC
1010 LAKE ST STE 110
OAK PARK, IL 60301-1106
Phone number: 331-529-7413
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Mailing Address
RICHARD HENRY LOGAN PMHNP-BC
8649 NEW ENGLAND AVE
BURBANK, IL 60459-2216
Phone number: 708-548-8308
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