Active NPI
Heart of Rose Psychiatry LLC
- Psychiatric/Mental Health Nurse Practitioner
- Olympia Fields, IL
National Provider Identifier
1295504959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- HEART OF ROSE PSYCHIATRY LLC
- Practice address
- 20200 Governors Dr Ste 328
Olympia Fields, IL 60461-1032 - Phone
- (773) 657-9003
- Fax
- (773) 648-8443
- NPI assigned
- Dec 22, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Brown Ehis, PMHNP
- Title
- Pmhnp
- Phone
- (773) 716-6869
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
20200 Governors Dr Ste 328
Olympia Fields, IL 60461-1032
Mailing address
6006 Colgate LN
Matteson, IL 60443-1995
National Provider Directory
National Provider DirectoryLocations
20200 Governors Dr
Ste 328
Olympia Flds, IL 60461
Phone (773) 657-9003
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1703203200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1714003200000",
"number": "1295504959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6006 COLGATE LN",
"city": "MATTESON",
"state": "IL",
"postal_code": "604431995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20200 GOVERNORS DR STE 328",
"city": "OLYMPIA FIELDS",
"state": "IL",
"postal_code": "604611032",
"telephone_number": "773-657-9003",
"fax_number": "773-648-8443"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEART OF ROSE PSYCHIATRY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-12-22",
"last_updated": "2024-04-25",
"certification_date": "2024-04-25",
"status": "A",
"authorized_official_last_name": "EHIS",
"authorized_official_first_name": "BROWN",
"authorized_official_title_or_position": "PMHNP",
"authorized_official_telephone_number": "773-716-6869",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "PMHNP"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Olympia Fields, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.