MEDICARE: JOSEPH WILLIAM HALLORAN NP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	273034	AZ
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	896924	NV

General Provider Information

NPI Number	:	1780534719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH WILLIAM HALLORAN NP

Provider Business Mailing Address
First Line	:	1357 CUMBERLAND CIR E
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3803
Country	:	US
Telephone Number	:	847-217-9106
Fax Number	:

Provider Business Practice Location Address
First Line	:	2501 N HAYDEN RD STE 103
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85257-2326
Country	:	US
Telephone Number	:	480-630-9219
Fax Number	:

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

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	02/13/2026

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