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Individual

MICHAEL MCKINLEY HALLBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1549 W CHESTNUT ST, CHICAGO, IL 60642-5202
(319) 321-9481
Mailing address
1549 W CHESTNUT ST, CHICAGO, IL 60642-5202
(319) 321-9481

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036115546
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036115546
IL
Enumeration date
05/10/2007
Last updated
03/09/2011
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