| NPI | 1659135416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS O NYENKE Provider/Owner 312-857-4475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2024-07-05 |