Healthcare Provider Details

I. General information

NPI: 1366334013
Provider Name (Legal Business Name): ISABELLE HALLE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 LAKE COOK RD
DEERFIELD IL
60015-4920
US

IV. Provider business mailing address

770 LAKE COOK RD
DEERFIELD IL
60015-4920
US

V. Phone/Fax

Practice location:
  • Phone: 603-828-9440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146.029034
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: