Healthcare Provider Details

I. General information

NPI: 1326385824
Provider Name (Legal Business Name): DEBORAH FRANCINE BUMP PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEBORAH FRANCINE RICHMOND RN

II. Dates (important events)

Enumeration Date: 01/03/2013
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 W MAXWELL ST
CHICAGO IL
60607-5002
US

IV. Provider business mailing address

6918 S EUCLID AVE
CHICAGO IL
60649-1512
US

V. Phone/Fax

Practice location:
  • Phone: 866-600-2273
  • Fax:
Mailing address:
  • Phone: 773-401-6167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number277000424
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: