Provider Demographics
NPI:1174708465
Name:HERR, JULIE M (MS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:HERR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:HERR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:2032 W GRAND AVE
Mailing Address - Street 2:APT. 2406
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-1502
Mailing Address - Country:US
Mailing Address - Phone:312-388-8883
Mailing Address - Fax:
Practice Address - Street 1:2032 W GRAND AVE
Practice Address - Street 2:APT. 2406
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-1502
Practice Address - Country:US
Practice Address - Phone:312-388-8883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILJH07000505P174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist