MEDICARE: BRIANNA J HALEY

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	171W00000X	Contractor

General Provider Information

NPI Number	:	1750274411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA J HALEY

Provider Business Mailing Address
First Line	:	1552 S ROUTE 59
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-5941
Country	:	US
Telephone Number	:	815-414-6498
Fax Number	:

Provider Business Practice Location Address
First Line	:	1552 S ROUTE 59
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-5941
Country	:	US
Telephone Number	:	815-414-6498
Fax Number	:

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

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	06/02/2025

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Directions to “ BRIANNA J HALEY ” Practice Location

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