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NPI Code Detail

MEDICARE: TAMEKA HANEY

MEDICARE: TAMEKA HANEY
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1730843277
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMEKA HANEY
Provider Business Mailing Address
First Line : 5705 WILLOW SPRINGS RD
Second Line :
City : COUNTRYSIDE
State : IL
Zip : 60525-3478
Country : US
Telephone Number : 312-965-2997
Fax Number :
Provider Business Practice Location Address
First Line : 5705 WILLOW SPRINGS RD
Second Line :
City : COUNTRYSIDE
State : IL
Zip : 60525-3478
Country : US
Telephone Number : 312-965-2997
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2021
Last Update Date : 10/29/2021

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Directions to “ TAMEKA HANEY ” Practice Location

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