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General NPI Number Information
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NPI Number | 1093067605
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Entity Type | Individual
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Provider Name | JOANA HAYMON CRT
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Gender | Female
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Dates
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Enumeration Date | 10/05/2012
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Last Update Date | 10/05/2012
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Provider Practice Location Address
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Address Line | 820 S DAMEN AVE
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City | CHICAGO
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State | IL
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Zip | 60612-3728
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Country | US
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Telephone | 773-998-6061
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Fax |
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Provider Business Mailing Address
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Address Line | 3630 W 120TH PL APT 2S
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City | ALSIP
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State | IL
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Zip | 60803-1251
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Country | US
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Telephone | 773-998-6061
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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 | 227800000X
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Taxonomy Name | Certified Respiratory Therapist
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License Number | 194009026
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License Number State | IL
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