Ann Alicya Blymire

Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · Northfield, IL

NPI 1124663398 · NPPES record last updated Nov 12, 2019

Key facts

NPI
1124663398
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Registered Nurse 163WP0808X
License
041.405632 (IL)
Practice address
405 Central Ave
Northfield, IL 60093-3006
Phone
(847) 441-6500
NPI assigned
Nov 12, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
041.405632ILMDPsychiatric/Mental Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 041.405632 IL Yes

Addresses

Primary practice location

405 Central Ave
Northfield, IL 60093-3006

Mailing address

4003 Chester Dr
Glenview, IL 60026-1048
Phone (610) 864-1222

Other providers in Northfield, IL

All providers in Northfield, IL · Psychiatric/Mental Health Registered Nurse in Illinois

Sources for this page

Verify at the official NPI Registry.