Organization
LESLIE MCILVRIED APRN BC LLC
Active
Other names
Leslie McIlvried APRN BC LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE MCILVRIED APRN BC (NURSE PRACTITIONER)
(630) 983-8920
Entity
Organization
Contact information
Practice address
1755 PARK ST, NAPERVILLE, IL 60563-4861
(630) 983-8920
(630) 983-4839
Mailing address
1755 PARK ST, NAPERVILLE, IL 60563-4861
(630) 983-8920
(630) 983-4839
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
041410686
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225098445
NPI TYPE 1
—
Enumeration date
05/16/2017
Last updated
07/21/2022
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