Healthcare Provider Details

I. General information

NPI: 1437827037
Provider Name (Legal Business Name): ERICKA EYAS MSN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 08/31/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 LARKIN AVE
ELGIN IL
60123-4405
US

IV. Provider business mailing address

25W270 ARMBRUST AVE
WHEATON IL
60187-3487
US

V. Phone/Fax

Practice location:
  • Phone: 847-697-2400
  • Fax:
Mailing address:
  • Phone: 630-886-0519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209.023759
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: