Provider Demographics
NPI:1932331329
Name:HALPER, DELLA MADELINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DELLA
Middle Name:MADELINE
Last Name:HALPER
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 1:2210 DEAN ST STE I
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-1067
Mailing Address - Country:US
Mailing Address - Phone:630-584-2450
Mailing Address - Fax:
Practice Address - Street 1:2210 DEAN ST STE I
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-1067
Practice Address - Country:US
Practice Address - Phone:630-584-2450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-004953103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical