Individual
KRISTEN MCCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8311 ROOSEVELT RD, FOREST PARK, IL 60130-2500
(708) 771-7000
Mailing address
7402 DEVEREUX RD, DOWNERS GROVE, IL 60516-3741
(248) 672-4448
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.021532
IL
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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