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General NPI Number Information
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NPI Number | 1568190114
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Entity Type | Individual
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Provider Name | HALEY MARIE HUTCHERSON APRN
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Gender | Female
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Dates
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Enumeration Date | 08/11/2022
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Last Update Date | 04/04/2023
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Provider Practice Location Address
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Address Line | 9718 S HALSTED ST
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City | CHICAGO
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State | IL
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Zip | 60628-1007
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Country | US
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Telephone | 773-233-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 455 E WATERSIDE DR UNIT 3014
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City | CHICAGO
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State | IL
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Zip | 60601-0020
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Country | US
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Telephone | 817-586-8003
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 209.025711
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License Number State | IL
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