Organization
EVIE LIFE PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMUENTIYAN FAITH OYESIKU (PSYCHIATRIC NURSE PRACTITIONER)
(708) 439-8834
Entity
Organization
Contact information
Practice address
340 W BUTTERFIELD RD, ELMHURST, IL 60126-5069
(312) 779-6778
Mailing address
836 S SPRING RD, ELMHURST, IL 60126-4726
(312) 779-6778
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/18/2023
Last updated
04/15/2024
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