Provider Demographics
NPI:1093562076
Name:HADD, EMELENE MARIE
Entity type:Individual
Prefix:
First Name:EMELENE
Middle Name:MARIE
Last Name:HADD
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 1:2408 W GRENSHAW ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4939
Mailing Address - Country:US
Mailing Address - Phone:989-415-4751
Mailing Address - Fax:
Practice Address - Street 1:9944 S ROBERTS RD STE 202
Practice Address - Street 2:
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-1558
Practice Address - Country:US
Practice Address - Phone:872-760-3457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist