Individual
HAYLEY JAFFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2311 EDNA AVE, PARK RIDGE, IL 60068-1811
(847) 825-5984
Mailing address
2311 EDNA AVE, PARK RIDGE, IL 60068-1811
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XOH839229954
BLUECROSS BLUESHIELD HMO
IL
Enumeration date
02/14/2019
Last updated
02/14/2019
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