Healthcare Provider Details

I. General information

NPI: 1346754835
Provider Name (Legal Business Name): DETONYA ARMSTRONG FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2017
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8556 S ASHLAND AVE
CHICAGO IL
60620-4709
US

IV. Provider business mailing address

8556 S ASHLAND AVE
CHICAGO IL
60620-4709
US

V. Phone/Fax

Practice location:
  • Phone: 708-973-8071
  • Fax: 620-205-4129
Mailing address:
  • Phone: 708-973-8071
  • Fax: 620-205-4129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277002344
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.016912
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number277002344
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: