Healthcare Provider Details

I. General information

NPI: 1548426505
Provider Name (Legal Business Name): WHITNEY HABERMANN OPPENHEIMER M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WHITNEY SPEAKER HABERMANN M.A.

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W BUENA AVE
CHICAGO IL
60613-1612
US

IV. Provider business mailing address

1139 W MONTANA ST
CHICAGO IL
60614-2220
US

V. Phone/Fax

Practice location:
  • Phone: 773-327-6000
  • Fax:
Mailing address:
  • Phone: 773-206-8182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180005635
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: