| NPI | 1801692082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CERES KANGOU Nurse Practitioner 630-974-9204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2025-02-19 |
| Last Update Date | 2025-02-19 |