Evie Life Psychiatry LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

EVIE LIFE PSYCHIATRY LLC

Practice address

340 W Butterfield Rd
Elmhurst, IL 60126-5069

Phone

(312) 779-6778

NPI assigned

Dec 18, 2023

Last updated

Apr 15, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Imuentiyan Faith OyesikuNPI 1467064154

Title

Psychiatric Nurse Practitioner

Phone

(708) 439-8834

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Imuentiyan Faith Oyesiku

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
  • NPI 1467064154
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1306614664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 S SPRING RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601264726",
            "telephone_number": "312-779-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 W BUTTERFIELD RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265069",
            "telephone_number": "312-779-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVIE LIFE PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-18",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A",
        "authorized_official_last_name": "OYESIKU",
        "authorized_official_first_name": "IMUENTIYAN",
        "authorized_official_middle_name": "FAITH",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "708-439-8834"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Dale Eschenbaum, D.C.
• Michael Escoto, DO
• Odeta Espinoza, LPC
• Val Evalen, M.D
• Carol Ann Everett, PTA, BS
• Marilyn L Evrard, MD
• Michael Darrell Ewers, D.D.S.
• Diane D Fabrizius, MD
• Hannah Fakhoury, M.A. CCC-SLP
• Suzanne Danielle Faleni, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.