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General NPI Number Information
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NPI Number | 1306355151
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Entity Type | Individual
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Provider Name | LINDA MARIE HARTY
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Gender | Female
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Dates
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Enumeration Date | 09/25/2017
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Last Update Date | 09/25/2017
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Provider Practice Location Address
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Address Line | 1340 S DAMEN AVE STE 400
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City | CHICAGO
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State | IL
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Zip | 60608-1169
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Country | US
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Telephone | 773-292-4800
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Fax | 312-564-4059
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Provider Business Mailing Address
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Address Line | 7754 W HIGGINS RD
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City | CHICAGO
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State | IL
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Zip | 60631-3350
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Country | US
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Telephone | 312-415-7952
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Fax | 312-564-4059
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN178573
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041134038
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License Number State | IL
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