Individual
MICHELLE MARIE HARTNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
636 RAYMOND DR STE 107, NAPERVILLE, IL 60563-9789
(630) 359-8396
(630) 933-2729
Mailing address
15300 WEST AVE # LL, ORLAND PARK, IL 60462-4600
(708) 923-5550
(708) 226-2595
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.005991
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400369902
MEDICARE PTAN
IL
Enumeration date
10/18/2016
Last updated
06/13/2022
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