Healthcare Provider Details

I. General information

NPI: 1265352645
Provider Name (Legal Business Name): DENNIS MICHAEL TAYLOR APN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

852 S WEST ST
NAPERVILLE IL
60540-6400
US

IV. Provider business mailing address

4515 BLACKHAWK LN APT 102
LISLE IL
60532-1563
US

V. Phone/Fax

Practice location:
  • Phone: 630-305-5075
  • Fax:
Mailing address:
  • Phone: 773-510-3885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209035002
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: