Provider Demographics
NPI:1447490305
Name:HALLEZ, MARC EMILE (RN)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:EMILE
Last Name:HALLEZ
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-4349
Mailing Address - Country:US
Mailing Address - Phone:847-651-5675
Mailing Address - Fax:
Practice Address - Street 1:1630 W CONGRESS PARKWAY
Practice Address - Street 2:RUSH HEALTH ASSOCIATES
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-563-4082
Practice Address - Fax:312-563-4402
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.347466163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator