Provider Demographics
NPI:1932701653
Name:HALLAK, NADIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NADIA
Middle Name:
Last Name:HALLAK
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 1:535 N MICHIGAN AVE APT 1608
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3810
Mailing Address - Country:US
Mailing Address - Phone:312-659-9606
Mailing Address - Fax:
Practice Address - Street 1:535 N MICHIGAN AVE APT 1608
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3810
Practice Address - Country:US
Practice Address - Phone:312-659-9606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.016179101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional