Healthcare Provider Details

I. General information

NPI: 1932003092
Provider Name (Legal Business Name): MISHKA JANELLE AREVALO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 LAKEVIEW PKWY STE 150
VERNON HILLS IL
60061-1839
US

IV. Provider business mailing address

920 WESTMORELAND DR APT 10
VERNON HILLS IL
60061-2850
US

V. Phone/Fax

Practice location:
  • Phone: 877-486-4140
  • Fax:
Mailing address:
  • Phone: 847-525-7586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number2821771
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: