Provider Demographics
NPI:1780466235
Name:AMEYAW, LINDA ABANKWA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ABANKWA
Last Name:AMEYAW
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8947 S RIDGELAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-2837
Mailing Address - Country:US
Mailing Address - Phone:773-430-2737
Mailing Address - Fax:
Practice Address - Street 1:8947 S RIDGELAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-2837
Practice Address - Country:US
Practice Address - Phone:773-430-2737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.028275363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health