Individual
DEBORA DELRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, PMHNP-BC
Contact information
Practice address
640 S WASHINGTON ST, NAPERVILLE, IL 60540-6603
(815) 942-6323
(779) 210-5541
Mailing address
PO BOX 713260, CHICAGO, IL 60677-0264
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209014185
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400292315
MEDICARE PTAN
IL
Enumeration date
04/12/2016
Last updated
05/19/2023
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