Individual
DEVIN D HAERTLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4121 VETERANS MEMORIAL DR, MOUNT VERNON, IL 62864-6262
(618) 242-3778
(618) 242-2551
Mailing address
4121 VETERANS MEMORIAL DR, MOUNT VERNON, IL 62864-6262
(618) 242-3778
(618) 242-2551
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085003979
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085003979
STATE LICENSE
IL
Enumeration date
01/27/2011
Last updated
01/27/2011
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