| Doctor Name: | MRS. MICHELLE TALLEY |
| NPI Number: | 1114168630 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 041345097 |
| Business Practice Address: | 12 Health Services Dr Dekalb, IL - 601159637 |
| Business Phone Number: | 8157564875 |
| Business Fax Number: | 8157562944 |
| Mailing Address: | 12 Health Services Dr, DEKALB |
| State: | IL |
| Postal Code: | 601159637 |
| Phone Number: | 8157564875 |
| Fax Number: | 8157562944 |
| NPI Enumeration Date: | 03/12/2009 |
| NPI Last Update Date: | 03/12/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 041345097 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |