Individual
MS. ANTONIA HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1004 PAWLAK PKWY, NEW LENOX, IL 60451-9401
(815) 215-3400
(815) 215-3400
Mailing address
1004 PAWLAK PKWY, NEW LENOX, IL 60451-9401
(815) 215-3300
(815) 215-3400
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209019331
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154527166
—
NJ
Enumeration date
06/26/2007
Last updated
02/19/2020
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