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General NPI Number Information
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NPI Number | 1215742481
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Entity Type | Individual
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Provider Name | EVGENIYA MOGILEVSKAYA APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 2500 W HIGGINS RD STE 210
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-7234
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Country | US
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Telephone | 224-489-3888
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Fax |
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Provider Business Mailing Address
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Address Line | 6697 GILMER RD
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City | LONG GROVE
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State | IL
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Zip | 60047-5185
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Country | US
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Telephone | 847-778-1211
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 209.031119
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License Number State | IL
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