Provider Demographics
NPI:1568983765
Name:POLGAR, HAIDEE MAURA (NP)
Entity Type:Individual
Prefix:
First Name:HAIDEE
Middle Name:MAURA
Last Name:POLGAR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3107 ANTON DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-6665
Mailing Address - Country:US
Mailing Address - Phone:331-725-1532
Mailing Address - Fax:630-984-7427
Practice Address - Street 1:1755 PARK ST STE 200
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8404
Practice Address - Country:US
Practice Address - Phone:630-486-3664
Practice Address - Fax:630-984-7427
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-28
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.016112363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology