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General NPI Number Information
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NPI Number | 1114502721
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Entity Type | Organization
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Legal Business Name | EH2 PSYCHIATRY PLLC
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Dates
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Enumeration Date | 03/15/2021
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 642 INDIAN RIDGE DR
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City | ANTIOCH
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State | IL
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Zip | 60002-3102
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Country | US
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Telephone | 847-708-1197
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Fax | 847-221-6869
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Provider Business Mailing Address
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Address Line | 6615 GRAND AVE # 241
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City | GURNEE
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State | IL
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Zip | 60031-4591
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Country | US
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Telephone | 847-961-2875
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Fax | 847-221-6869
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Authorized Official
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Title or Position | OWNER/NP
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Name | DR. ANGELA SUE PETERS
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Credential | NP
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Telephone | 847-961-2875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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