Individual
THERESA A LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
440 LAKE COOK RD STE 2, DEERFIELD, IL 60015-5263
(847) 236-9310
(847) 236-9411
Mailing address
440 LAKE COOK RD STE 2, DEERFIELD, IL 60015-5263
(847) 236-9310
(847) 236-9411
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.029761
IL
Other
Enumeration date
05/31/2024
Last updated
05/31/2024
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