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General NPI Number Information
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NPI Number | 1427978915
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Entity Type | Organization
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Legal Business Name | TAPESTRY 360 HEALTH
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Dates
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Enumeration Date | 07/16/2026
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Last Update Date | 07/16/2026
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Provider Practice Location Address
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Address Line | 6200 N HIAWATHA AVE
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City | CHICAGO
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State | IL
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Zip | 60646-4309
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Country | US
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Telephone | 773-296-7589
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 W DEVON AVE
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City | CHICAGO
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State | IL
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Zip | 60660-1329
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. NICOLE WILLIS
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Credential | MBA
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Telephone | 773-296-7589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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