Healthcare Provider Details

I. General information

NPI: 1679160949
Provider Name (Legal Business Name): GHISLAINE TONYE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2020
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 W BELMONT AVE
CHICAGO IL
60657-0939
US

IV. Provider business mailing address

1416 W BELMONT AVE
CHICAGO IL
60657-0939
US

V. Phone/Fax

Practice location:
  • Phone: 630-884-4940
  • Fax: 630-358-6826
Mailing address:
  • Phone: 630-884-4940
  • Fax: 630-358-6826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number377004236
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1021335
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61415791
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: