Provider Demographics
NPI:1669081048
Name:NZINGA, HALEY
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:NZINGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 W HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH
Mailing Address - State:IL
Mailing Address - Zip Code:61462-1006
Mailing Address - Country:US
Mailing Address - Phone:224-489-3512
Mailing Address - Fax:
Practice Address - Street 1:1120 RANDALL CT
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-3911
Practice Address - Country:US
Practice Address - Phone:630-232-1070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator