Healthcare Provider Details

I. General information

NPI: 1184151193
Provider Name (Legal Business Name): HAILI M CAMPANELLA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HAILI M ADAMS NP

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 N SHERIDAN RD
WAUKEGAN IL
60085-2161
US

IV. Provider business mailing address

18820 W PARK CRES
LAKE VILLA IL
60046-9022
US

V. Phone/Fax

Practice location:
  • Phone: 847-360-9800
  • Fax:
Mailing address:
  • Phone: 262-422-7882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number277003027
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041419742
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number209015946
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: