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General NPI Number Information
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NPI Number | 1508049552
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Entity Type | Individual
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Provider Name | AMY LYNN ADAMS APN, FNP, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 1801 INGALLS AVE
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City | JOLIET
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State | IL
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Zip | 60435-7903
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Country | US
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Telephone | 815-326-5538
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Fax |
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Provider Business Mailing Address
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Address Line | 4525 N RAVENSWOOD AVE STE 201
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City | CHICAGO
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State | IL
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Zip | 60640-5201
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Country | US
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Telephone | 312-857-8794
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Fax | 708-575-8311
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 277.000764
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 277.000764
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License Number State | IL
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