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General NPI Number Information
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NPI Number | 1285403253
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Entity Type | Organization
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Legal Business Name | ALTASANO PC
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Dates
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Enumeration Date | 01/01/2024
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 7432 HANCOCK DR
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City | WONDER LAKE
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State | IL
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Zip | 60097-9200
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Country | US
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Telephone | 815-307-6717
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Fax | 833-523-2350
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Provider Business Mailing Address
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Address Line | 7432 HANCOCK DR
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City | WONDER LAKE
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State | IL
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Zip | 60097-9200
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Country | US
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Telephone | 815-307-6717
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Fax | 833-523-2350
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Authorized Official
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Title or Position | PRESIDENT
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Name | DEENA C SCHWARTZ
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Credential | PMHNP-FPA
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Telephone | 815-307-6717
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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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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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