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General NPI Number Information
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NPI Number | 1336697234
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Entity Type | Individual
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Provider Name | LAURA GRECO FNP, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 09/20/2016
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 1909 OGDEN AVE STE A
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-2602
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Country | US
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Telephone | 630-750-7920
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Fax | 888-309-5146
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Provider Business Mailing Address
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Address Line | 616 S CUMBERLAND AVE
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City | PARK RIDGE
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State | IL
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Zip | 60068-4631
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Country | US
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Telephone | 708-819-7720
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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 | 209012390
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209014817
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License Number State | IL
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