Provider Demographics
NPI:1114502721
Name:EH2 PSYCHIATRY PLLC
Entity Type:Organization
Organization Name:EH2 PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NP
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:847-961-2875
Mailing Address - Street 1:6615 GRAND AVE # 241
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-4591
Mailing Address - Country:US
Mailing Address - Phone:847-961-2875
Mailing Address - Fax:847-221-6869
Practice Address - Street 1:642 INDIAN RIDGE DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:IL
Practice Address - Zip Code:60002-3102
Practice Address - Country:US
Practice Address - Phone:847-708-1197
Practice Address - Fax:847-221-6869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-15
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty