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Individual

MRS. HALEY JANE BREWER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
22285 N PEPPER RD STE 302, LAKE BARRINGTON, IL 60010-2541
(847) 726-0774
(847) 277-1549
Mailing address
3880 SALEM LAKE DR STE F, LONG GROVE, IL 60047-5292
(847) 719-2220
(847) 719-2265

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.009231
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
085009231
IL
01
MB7618789
DEA
IL
Enumeration date
09/26/2022
Last updated
01/10/2024
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