| NPI | 1265124846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS VAN BYSSUM Member/Owner 630-858-0875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2023-11-07 |