Individual
DIANE IRISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
467 E 31ST ST, CHICAGO, IL 60616-4051
(312) 572-3050
(312) 572-3060
Mailing address
1950 W POLK ST, CHICAGO, IL 60612-3723
(312) 864-0200
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209027202
IL
Other
Enumeration date
02/10/2015
Last updated
10/27/2025
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