Individual
JULENE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
14 LAKE ST, OAK PARK, IL 60302-2606
(708) 383-0113
Mailing address
14 LAKE ST, OAK PARK, IL 60302-2606
(708) 383-0113
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209025749
IL
Other
Enumeration date
06/30/2022
Last updated
11/15/2023
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