Provider Demographics
NPI:1639775281
Name:BALE, ANNETTE (APRN)
Entity type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:
Last Name:BALE
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-2321
Mailing Address - Country:US
Mailing Address - Phone:847-377-8950
Mailing Address - Fax:
Practice Address - Street 1:6525 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-2967
Practice Address - Country:US
Practice Address - Phone:877-201-0290
Practice Address - Fax:262-821-6180
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI121496-30163W00000X
IL041.273400163WA0400X
IL209024477363LP0808X
WI16340-33363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)