| Doctor Name: | DUSTIN A. TAYLOR |
| NPI Number: | 1023352853 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PMHNP |
| License Number: | 53-76164-082 |
| Business Practice Address: | 3001 Green Bay Rd North Chicago, IL - 600643048 |
| Business Phone Number: | 2246103744 |
| Business Fax Number: | |
| Mailing Address: | 3001 Green Bay Rd, NORTH CHICAGO |
| State: | IL |
| Postal Code: | 600643048 |
| Phone Number: | 2246103744 |
| Fax Number: | |
| NPI Enumeration Date: | 11/16/2012 |
| NPI Last Update Date: | 12/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | 53-76164-082 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |