| NPI | 1124804943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIA M. CHAPPLE Psychiatric Nurse Practitioner 224-970-7868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2025-09-19 |