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NPI Code Detail

MEDICARE: CADMONA ALEXANDRA HALL PH.D.

MEDICARE: CADMONA ALEXANDRA HALL PH.D.
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
1106H00000XMarriage & Family Therapist166.000896IL
2106H00000XMarriage & Family Therapist000919NY

General Provider Information

NPI Number : 1619295250
Entity Type Code : Individual
Provider Name (Legal Business Name) : CADMONA ALEXANDRA HALL PH.D.
Provider Business Mailing Address
First Line : 17 N DEARBORN ST
Second Line :
City : CHICAGO
State : IL
Zip : 60602-4310
Country : US
Telephone Number : 315-278-3668
Fax Number :
Provider Business Practice Location Address
First Line : 17 N DEARBORN ST
Second Line :
City : CHICAGO
State : IL
Zip : 60602-4310
Country : US
Telephone Number : 312-662-4326
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2010
Last Update Date : 01/08/2016

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