| Erica Gaddy Aprn | |
|
60 Revere Dr Ste 100 Northbrook IL 60062-1590 | |
| (224) 306-1879 | |
| Not Available |
| Full Name | Erica Gaddy Aprn |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 60 Revere Dr Ste 100, Northbrook, Illinois |
| Authorized Official Name and Position | Erica Gaddy (OWNER) |
| Authorized Official Contact | 2243061879 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Erica Gaddy Aprn 60 Revere Dr Ste 100 Northbrook IL 60062-1590 Ph: (224) 306-1879 | Erica Gaddy Aprn 60 Revere Dr Ste 100 Northbrook IL 60062-1590 Ph: (224) 306-1879 |
| NPI Number | 1316558471 |
|---|---|
| Provider Enumeration Date | 08/12/2020 |
| Last Update Date | 08/12/2020 |
| Certification Date | 08/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316558471 | NPI | - | NPPES |
| 12779892 | Other | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
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