Healthcare Provider Details

I. General information

NPI: 1164234779
Provider Name (Legal Business Name): CHLOE B SHEEHAN NP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 PATRIOT BLVD STE 250
GLENVIEW IL
60026-8021
US

IV. Provider business mailing address

638 S OAKLAND AVE
VILLA PARK IL
60181-3076
US

V. Phone/Fax

Practice location:
  • Phone: 847-629-4696
  • Fax:
Mailing address:
  • Phone: 630-956-4176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209.030910
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: