Healthcare Provider Details

I. General information

NPI: 1104172691
Provider Name (Legal Business Name): BARBARA LEE HARTNETT MS,NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2012
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 N MICHIGAN AVE
CHICAGO IL
60611-2615
US

IV. Provider business mailing address

737 N MICHIGAN AVE
CHICAGO IL
60611-2615
US

V. Phone/Fax

Practice location:
  • Phone: 312-440-3810
  • Fax: 312-440-3817
Mailing address:
  • Phone: 312-440-3810
  • Fax: 312-440-3817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number209.006737
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: