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General NPI Number Information
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NPI Number | 1063978476
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Entity Type | Individual
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Provider Name | ANDREW STEVEN HALLUM FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 02/11/2019
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1710 N RANDALL RD STE 200
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City | ELGIN
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State | IL
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Zip | 60123-9402
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Country | US
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Telephone | 847-214-5740
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Fax | 847-214-5757
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.018675
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License Number State | IL
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