Individual
THERA AYESH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10717 GIGI DR # 60462, ORLAND PARK, IL 60462-2818
(708) 407-1124
Mailing address
10717 GIGI DR # 60462, ORLAND PARK, IL 60462-2818
(708) 407-1124
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209035398
IL
Other
Enumeration date
04/27/2026
Last updated
04/27/2026
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