| NPI | 1417464918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIQUE L MANDERSON CEO/Founder 708-679-4927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.012605) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2025-03-05 |