| Van Byssum Associates, Pc | |
|
174 S Montclair Ave Glen Ellyn IL 60137-6357 | |
| (630) 858-0875 | |
| (630) 858-0650 |
| Full Name | Van Byssum Associates, Pc |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 174 S Montclair Ave, Glen Ellyn, Illinois |
| Authorized Official Name and Position | Doris M Van Byssum (PRESIDENT/OWNER) |
| Authorized Official Contact | 6308580875 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Van Byssum Associates, Pc 174 S Montclair Ave Glen Ellyn IL 60137-6357 Ph: (630) 858-0875 | Van Byssum Associates, Pc 174 S Montclair Ave Glen Ellyn IL 60137-6357 Ph: (630) 858-0875 |
| NPI Number | 1497949762 |
|---|---|
| Provider Enumeration Date | 08/30/2007 |
| Last Update Date | 03/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497949762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071004744 (Illinois) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 209.010527041.189584 (Illinois) | Primary |
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