MEDICARE: MICHELLE A HARRIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	277.001829	IL

General Provider Information

NPI Number	:	1023144391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE A HARRIS

Provider Business Mailing Address
First Line	:	2045 PLUM GROVE RD
Second Line	:
City	:	ROLLING MEADOWS
State	:	IL
Zip	:	60008-1992
Country	:	US
Telephone Number	:	847-303-2450
Fax Number	:

Provider Business Practice Location Address
First Line	:	2045 PLUM GROVE RD
Second Line	:
City	:	ROLLING MEADOWS
State	:	IL
Zip	:	60008-1992
Country	:	US
Telephone Number	:	847-303-2450
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	01/06/2025

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Directions to “ MICHELLE A HARRIS ” Practice Location

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