Individual
DEIDRA HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1616 GRAND AVE, WAUKEGAN, IL 60085-3600
(847) 249-1733
Mailing address
8702 SEDGE MEADOW DR, WONDER LAKE, IL 60097-7604
(312) 399-1725
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.030954
IL
Other
Enumeration date
12/03/2024
Last updated
07/18/2025
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