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NPI 1881897486

NPI 1881897486 : NELLY PRESCILLA NORRELL MD : MAYWOOD, IL

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General NPI Number Information
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    NPI Number           |    1881897486
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    Entity Type          |    Individual 
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    Provider Name        |    NELLY PRESCILLA NORRELL MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/09/2007
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    Last Update Date     |    06/09/2025
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Provider Practice Location Address
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    Address Line         |    2160 S 1ST AVE 
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    City                 |    MAYWOOD
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    State                |    IL
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    Zip                  |    60153-3328
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    Country              |    US
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    Telephone            |    708-216-9000
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    Fax                  |    540-564-7171
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Provider Business Mailing Address
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    Address Line         |    2160 S 1ST AVE 
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    City                 |    MAYWOOD
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    State                |    IL
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    Zip                  |    60153-3328
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    Country              |    US
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    Telephone            |    708-216-9000
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    Fax                  |    540-564-7171
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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        |    2084P0800X
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    Taxonomy Name        |    Psychiatry Physician
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    License Number       |    0101250376
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    License Number State |    VA
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Taxonomy #2
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    Taxonomy Code        |    2084P0800X
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    Taxonomy Name        |    Psychiatry Physician
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    License Number       |    036142295
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    License Number State |    IL
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