Organization
WAVE BREAK PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVE HAYDT (OWNER)
(386) 503-1089
Entity
Organization
Contact information
Practice address
1014 W IRVING PARK RD APT 11, CHICAGO, IL 60613-7342
(386) 503-1089
Mailing address
2501 CHATHAM RD STE N, SPRINGFIELD, IL 62704-4188
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/10/2025
Last updated
06/10/2025
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