Provider Demographics
NPI:1659672830
Name:NEAL, CYNTHIA JO (MS, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:JO
Last Name:NEAL
Suffix:
Gender:F
Credentials:MS, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1858 NEWCASTLE AVE
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-4449
Mailing Address - Country:US
Mailing Address - Phone:708-227-0321
Mailing Address - Fax:
Practice Address - Street 1:1858 NEWCASTLE AVE
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-4449
Practice Address - Country:US
Practice Address - Phone:708-227-0321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277.000128363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health