Individual
BETH GABRIELLE DUDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
4753 NORTH BROADWAY ST, CHICAGO, IL 60640
(888) 279-0002
(866) 638-0302
Mailing address
1431 OPUS PL STE 110, DOWNERS GROVE, IL 60515-1164
(888) 279-0002
(866) 638-0302
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1158128
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3016425
KY
Other
Enumeration date
03/07/2021
Last updated
12/27/2024
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