Provider Demographics
NPI:1982447678
Name:HEALY, JOHN O
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:O
Last Name:HEALY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:O
Other - Last Name:HEALY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:445 PARK AVE STE F
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-2766
Mailing Address - Country:US
Mailing Address - Phone:224-699-3888
Mailing Address - Fax:
Practice Address - Street 1:445 PARK AVE STE F
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:IL
Practice Address - Zip Code:60013-2766
Practice Address - Country:US
Practice Address - Phone:224-699-3888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker