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General NPI Number Information
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NPI Number | 1235896853
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Entity Type | Organization
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Legal Business Name | DRH PSYCHIATRY LLC
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Dates
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Enumeration Date | 11/18/2021
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 1655 S BLUE ISLAND AVE STE 382
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City | CHICAGO
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State | IL
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Zip | 60608-2133
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Country | US
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Telephone | 319-481-8077
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Fax | 318-242-7958
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Provider Business Mailing Address
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Address Line | 3159 10TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33713-6627
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Country | US
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Telephone | 319-481-8077
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DUSTIN HUSEMANN
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Credential | NP
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Telephone | 319-481-8077
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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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