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NPI Code Detail

MEDICARE: ALTASANO PC

MEDICARE: ALTASANO PC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner
2261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1285403253
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALTASANO PC
Provider Business Mailing Address
First Line : 7432 HANCOCK DR
Second Line :
City : WONDER LAKE
State : IL
Zip : 60097-9200
Country : US
Telephone Number : 815-307-6717
Fax Number : 833-523-2350
Provider Business Practice Location Address
First Line : 7432 HANCOCK DR
Second Line :
City : WONDER LAKE
State : IL
Zip : 60097-9200
Country : US
Telephone Number : 815-307-6717
Fax Number : 833-523-2350
Authorized Official
Title or Position : PRESIDENT
Name : DEENA C SCHWARTZ
Credential : PMHNP-FPA
Telephone Number : 815-307-6717
Provider Enumeration Date : 01/01/2024
Last Update Date : 03/26/2025

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Directions to “ALTASANO PC ” Practice Location

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