Individual
AMY E HAEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1725 W HARRISON ST, SUITE 309 PROFESSIONAL BUILDING, CHICAGO, IL 60612-3841
(312) 942-9472
(312) 942-9198
Mailing address
315 S RIDGELAND AVE, OAK PARK, IL 60302
(708) 386-9742
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209005493
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1616020
BC/BS
IL
Enumeration date
08/30/2006
Last updated
05/24/2013
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