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NPI Code Detail

MEDICARE: MICHAEL MCKINLEY HALLBERG M.D.

MEDICARE:   MICHAEL MCKINLEY HALLBERG  M.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
12084P0800XPsychiatry Physician036115546IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942414669
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL MCKINLEY HALLBERG M.D.
Provider Business Mailing Address
First Line : 1549 W CHESTNUT ST
Second Line :
City : CHICAGO
State : IL
Zip : 60642-5202
Country : US
Telephone Number : 319-321-9481
Fax Number :
Provider Business Practice Location Address
First Line : 1549 W CHESTNUT ST
Second Line :
City : CHICAGO
State : IL
Zip : 60642-5202
Country : US
Telephone Number : 319-321-9481
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 03/09/2011

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