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NPI Code Detail

MEDICARE: VANESSA CHEVON HOLLAND AAHCC

MEDICARE:   VANESSA CHEVON HOLLAND  AAHCC
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
1174H00000XHealth EducatorBRADLEY METHOD AAHCCIL
2374J00000XDoulaBRADLEY DOULA, AAHCCIL

General Provider Information

NPI Number : 1508278482
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA CHEVON HOLLAND AAHCC
Provider Business Mailing Address
First Line : 2401 N PERIWINKLE WAY
Second Line :
City : ROUND LAKE BEACH
State : IL
Zip : 60073-4038
Country : US
Telephone Number : 847-219-7345
Fax Number :
Provider Business Practice Location Address
First Line : 2401 N PERIWINKLE WAY
Second Line :
City : ROUND LAKE BEACH
State : IL
Zip : 60073-4038
Country : US
Telephone Number : 847-219-7345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2014
Last Update Date : 05/27/2014

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Directions to “ VANESSA CHEVON HOLLAND AAHCC” Practice Location

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