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Individual

MARY E DAVITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN, NP

Contact information

Practice address
1786 MOON LAKE BLVD, SUITE 104, HOFFMAN ESTATES, IL 60169-5029
(847) 755-8090
(847) 843-7393
Mailing address
1786 MOON LAKE BLVD, SUITE 104, HOFFMAN ESTATES, IL 60169-5029
(847) 755-8090
(847) 843-7393

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
041-321192
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209-007333
IL

Other

Enumeration date
07/14/2009
Last updated
07/14/2009
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