Organization
TLDUBOSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY DUBOSE BC-PMHNP, APRN (PSYCHIATRIC NURSE PRACTITIONER)
(401) 602-3938
Entity
Organization
Contact information
Practice address
17707 W DARTMOOR DR, GRAYSLAKE, IL 60030-1996
(401) 602-3938
Mailing address
17707 W DARTMOOR DR, GRAYSLAKE, IL 60030-1996
(401) 602-3938
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/27/2025
Last updated
08/27/2025
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