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General NPI Number Information
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NPI Number | 1952023467
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Entity Type | Individual
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Provider Name | AISHA BESANNA SEALS PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 9697 191ST ST STE 200
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City | MOKENA
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State | IL
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Zip | 60448-8617
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Country | US
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Telephone | 630-646-6540
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Fax | 630-646-6542
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Provider Business Mailing Address
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Address Line | 852 S WEST ST
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City | NAPERVILLE
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State | IL
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Zip | 60540-6400
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Country | US
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Telephone | 630-305-5027
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Fax | 630-527-3080
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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 | 209025888
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License Number State | IL
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