Healthcare Provider Details

I. General information

NPI: 1801231766
Provider Name (Legal Business Name): ERIN ELIZABETH BEAN BSN, ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2013
Last Update Date: 03/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 E HURON ST
CHICAGO IL
60611-2908
US

IV. Provider business mailing address

11610 BROOKSHIRE DR
ORLAND PARK IL
60467-7520
US

V. Phone/Fax

Practice location:
  • Phone: 312-926-4915
  • Fax:
Mailing address:
  • Phone: 708-476-2665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number209010406
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041371127
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: