Individual
JENNIFER HALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(708) 870-9105
Mailing address
11613 S MEADOW LANE DR, MERRIONETTE PARK, IL 60803-5884
(708) 870-9105
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
54392
IL
Other
Enumeration date
08/02/2019
Last updated
08/02/2019
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