Organization
BARBARA A. HALLSTROM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BARBARA A HALLSTROM MSW, LCSW (OWNER)
(815) 235-2353
Entity
Organization
Contact information
Practice address
1011 LORAS DR STE C, FREEPORT, IL 61032-6900
(815) 233-2524
Mailing address
5230 VILLAGE CT, ROCKFORD, IL 61108-6618
(815) 235-2353
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8932014
BCBS OF ILLINOIS
IL
Enumeration date
03/25/2008
Last updated
03/25/2008
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