Individual
AMY LOUISE SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
405 W SUPERIOR ST STE 422, CHICAGO, IL 60654-8561
(309) 825-5180
Mailing address
405 W SUPERIOR ST, CHICAGO, IL 60654-8559
(309) 825-5180
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209027113
IL
Other
Enumeration date
04/26/2023
Last updated
08/25/2023
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