MEDICARE: FELISHA HARMON APRN-BC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician

General Provider Information

NPI Number	:	1093352098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FELISHA HARMON APRN-BC LLC

Provider Business Mailing Address
First Line	:	PO BOX 506
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60065-0506
Country	:	US
Telephone Number	:	847-562-9505
Fax Number	:	623-666-6792

Provider Business Practice Location Address
First Line	:	2500 W BRADLEY PL STE 100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-4716
Country	:	US
Telephone Number	:	773-649-0759
Fax Number	:	224-205-3757

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SEFELISHA MARIE HARMON
Credential	:	APRN
Telephone Number	:	773-649-0759

Provider Enumeration Date	:	12/09/2019
Last Update Date	:	06/01/2026

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