Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 209005432 | IL |
NPI | 1023187069 |
---|---|
Provider Name | Kay Budick |
First Address | Orland Park, IL 60467-5701 |
Second Address | Orland Park, IL 60462-2897 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 29/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
K13960 | (02) | IL |