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Organization
PROGRESSIVE MENTAL HEALTH
Active
Organization
PROGRESSIVE MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERANN IVY APRN-FPA (APN)
(312) 285-2982
Entity
Organization
Contact information
Practice address
2259 W TAYLOR ST, CHICAGO, IL 60612-4233
(773) 517-8360
Mailing address
2259 W TAYLOR ST, CHICAGO, IL 60612-4233
(773) 517-8360
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
NULL
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
12/04/2020
Last updated
02/17/2021
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