| NPI | 1366000648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARAIAH LYLAH M NANO President 847-813-5779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2025-07-18 |