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NPI Code Detail

MEDICARE: MR. JAMES R HAIG LCSW

MEDICARE:  MR. JAMES R HAIG  LCSW
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
1104100000XSocial WorkerIL 149-005385IL

General Provider Information

NPI Number : 1699814277
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES R HAIG LCSW
Provider Business Mailing Address
First Line : 3020 W WILLOW KNOLLS DR
Second Line :
City : PEORIA
State : IL
Zip : 61614-8127
Country : US
Telephone Number : 309-681-5652
Fax Number : 309-681-5658
Provider Business Practice Location Address
First Line : 3020 W WILLOW KNOLLS DR
Second Line :
City : PEORIA
State : IL
Zip : 61614-8127
Country : US
Telephone Number : 309-681-5652
Fax Number : 309-681-5658
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2007
Last Update Date : 07/08/2007

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Directions to “ MR. JAMES R HAIG LCSW” Practice Location

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