Healthcare Provider Details

I. General information

NPI: 1902686090
Provider Name (Legal Business Name): VANESSA NICOLE WROBEL PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2023
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 RAVINE WAY
GLENVIEW IL
60025-7648
US

IV. Provider business mailing address

2440 RAVINE WAY
GLENVIEW IL
60025-7648
US

V. Phone/Fax

Practice location:
  • Phone: 847-730-3042
  • Fax: 847-904-2329
Mailing address:
  • Phone: 847-730-3042
  • Fax: 847-904-2329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.440529
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209.028364
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: