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NPI Code Detail

MEDICARE: MRS. KATHY BETTINARDI ANGRES APRN, PMHNP

MEDICARE: MRS. KATHY BETTINARDI ANGRES APRN, PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner277.003268IL

General Provider Information

NPI Number : 1639417736
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHY BETTINARDI ANGRES APRN, PMHNP
Provider Business Mailing Address
First Line : 1047 BRAEMOOR DR
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-5524
Country : US
Telephone Number : 708-822-2255
Fax Number :
Provider Business Practice Location Address
First Line : 1500 EISENHOWER LN STE 900
Second Line :
City : LISLE
State : IL
Zip : 60532-2135
Country : US
Telephone Number : 708-822-2555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2013
Last Update Date : 12/06/2024

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