MEDICARE: BRIDGET ANN HALVEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		IL

General Provider Information

NPI Number	:	1265362305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIDGET ANN HALVEY

Provider Business Mailing Address
First Line	:	6018 8TH AVE APT 34
Second Line	:
City	:	KENOSHA
State	:	WI
Zip	:	53143-4570
Country	:	US
Telephone Number	:	630-805-3732
Fax Number	:

Provider Business Practice Location Address
First Line	:	14245 W ROCKLAND RD
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-9745
Country	:	US
Telephone Number	:	847-362-4636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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Directions to “ BRIDGET ANN HALVEY ” Practice Location

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