Doctor Name: | DR. TERRILL K. HAWS |
NPI Number: | 1275742223 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | 036073100 |
Business Practice Address: | 14044 Petronella Dr Suite 3 Libertyville, IL - 600489656 |
Business Phone Number: | 8475491424 |
Business Fax Number: | 8475491424 |
Mailing Address: | 14044 W Petronella Dr, Suite 3 LIBERTYVILLE |
State: | IL |
Postal Code: | 600489656 |
Phone Number: | 8475491424 |
Fax Number: | 8475491424 |
NPI Enumeration Date: | 05/22/2007 |
NPI Last Update Date: | 01/12/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 036073100 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |