Provider Demographics
NPI:1073245205
Name:EMILY N HALLIDAY
Entity Type:Organization
Organization Name:EMILY N HALLIDAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:NAMASTE
Authorized Official - Last Name:HALLIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:847-899-0315
Mailing Address - Street 1:2518 THAYER ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1320
Mailing Address - Country:US
Mailing Address - Phone:847-899-0315
Mailing Address - Fax:
Practice Address - Street 1:2530 CRAWFORD AVE STE 118
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4954
Practice Address - Country:US
Practice Address - Phone:847-899-0315
Practice Address - Fax:224-228-0435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty