Provider Demographics
NPI:1083222491
Name:HENHAPL, MICHELE CAROLINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:CAROLINE
Last Name:HENHAPL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 SKOKIE BLVD STE 426
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4024
Mailing Address - Country:US
Mailing Address - Phone:312-481-8181
Mailing Address - Fax:
Practice Address - Street 1:899 SKOKIE BLVD STE 426
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4024
Practice Address - Country:US
Practice Address - Phone:312-481-8181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-21
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC2200X
IL071010099103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent