Healthcare Provider Details

I. General information

NPI: 1073371951
Provider Name (Legal Business Name): ANTONIO E HERNANDEZ-SILVA PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2024
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 LARKIN AVE
ELGIN IL
60123-4405
US

IV. Provider business mailing address

2050 LARKIN AVE
ELGIN IL
60123-4405
US

V. Phone/Fax

Practice location:
  • Phone: 847-697-2400
  • Fax:
Mailing address:
  • Phone: 847-697-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2024002710
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: