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Organization

BHS PHYSICIAN SERVICES OF ILLINOIS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JONATHAN HOREY (PRESIDENT)
(646) 479-9469
Entity
Organization

Contact information

Practice address
1237 E 1600 NORTH RD, GILMAN, IL 60938-6112
(844) 233-1806
Mailing address
160 CHUBB AVE STE 206, LYNDHURST, NJ 07071-3526

Taxonomy

Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
363L00000X
Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
02/13/2017
Last updated
02/13/2017
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