Elite Psychiatry And Wellness LLC
Nurse Practitioner, Psych/Mental Health in Mokena, IL. Organization (NPI-2).
NPI number1265166177
StatusActive
Last updated in NPPESJul 15, 2022
Details
- NPI
- 1265166177
- Entity type
- Organization (NPI-2)
- Legal business name
- Elite Psychiatry And Wellness LLC
- Organization subpart
- No
- Enumeration date
- Jul 15, 2022
- Certification date
- Jul 15, 2022
- Last updated
- Jul 15, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
Practice location
10010 W 190th PlMokena, IL 60448-8752
Phone 815-733-8019 · Fax 815-733-8019
Mailing address
10010 W 190th PlMokena, IL 60448-8752
Phone 815-733-8019 · Fax 815-733-8019
Authorized official
Medinat Balogun
Owner
7082712748
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