Organization
PSYGENIC HEALTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA OLUSOLA PMHNP (MANAGER)
(708) 879-2975
Entity
Organization
Contact information
Practice address
920 175TH ST STE 6, HOMEWOOD, IL 60430-2077
(708) 879-2975
(708) 365-2949
Mailing address
920 175TH ST STE 6, HOMEWOOD, IL 60430-2077
(708) 879-2975
(708) 365-2949
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
01/20/2025
Last updated
08/21/2025
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