Organization
ERICA JANE GADDY APRN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA GADDY APRN (OWNER)
(224) 306-1879
Entity
Organization
Contact information
Practice address
60 REVERE DR STE 100, NORTHBROOK, IL 60062-1590
(224) 306-1879
Mailing address
60 REVERE DR STE 100, NORTHBROOK, IL 60062-1590
(224) 306-1879
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12779892
CAQH
—
Enumeration date
08/12/2020
Last updated
08/12/2020
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