Healthcare Provider Details
I. General information
NPI: 1407718448
Provider Name (Legal Business Name): PATRICIA HESPEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/28/2025
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3317 W 95TH ST STE 101
EVERGREEN PARK IL
60805-2243
US
IV. Provider business mailing address
9808 S TRUMBULL AVE
EVERGREEN PARK IL
60805-3049
US
V. Phone/Fax
- Phone: 708-529-8483
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 178.022388 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 221700000X |
| Taxonomy | Art Therapist |
| License Number | 25-010 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: