Healthcare Provider Details

I. General information

NPI: 1528364346
Provider Name (Legal Business Name): ROBYE D BALLARD PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2011
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E OGDEN AVE STE 118
HINSDALE IL
60521-3776
US

IV. Provider business mailing address

201 E OGDEN AVE STE 118
HINSDALE IL
60521-3776
US

V. Phone/Fax

Practice location:
  • Phone: 630-270-7717
  • Fax:
Mailing address:
  • Phone: 630-270-7717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209.028428
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: