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General NPI Number Information
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NPI Number | 1346110764
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Entity Type | Organization
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Legal Business Name | KRYSTLE HARTE, LLC
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Dates
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Enumeration Date | 11/10/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 4S100 N ROUTE 59 STE 11
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City | WARRENVILLE
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State | IL
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Zip | 60563-0722
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Country | US
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Telephone | 407-982-4876
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Fax | 407-650-2754
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Provider Business Mailing Address
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Address Line | 4S100 N ROUTE 59 STE 11
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City | WARRENVILLE
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State | IL
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Zip | 60563-0722
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Country | US
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Telephone | 407-982-4876
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Fax | 407-650-2754
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Authorized Official
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Title or Position | OWNER
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Name | KRYSTLE HARTE
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Credential |
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Telephone | 407-982-4876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number |
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License Number State |
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