Healthcare Provider Details

I. General information

NPI: 1699205724
Provider Name (Legal Business Name): CLAIRE EMERY HAILEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2017
Last Update Date: 10/21/2020
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 PARK AVE W
HIGHLAND PARK IL
60035-2433
US

IV. Provider business mailing address

777 PARK AVE W
HIGHLAND PARK IL
60035-2433
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-2530
  • Fax:
Mailing address:
  • Phone: 847-570-2530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036152272
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036152272
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: