| NPI | 1982112389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HEYLAND Owner 847-257-2497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209010790) |
| Enumeration Date | 2018-01-19 |
| Last Update Date | 2018-01-19 |