Julie Kay Haggerty, APN
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Ellisville, IL
NPI 1790014520 · NPPES record last updated Aug 26, 2025
Key facts
- NPI
- 1790014520
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 209007867 (IL)
- Practice address
- 7662 E Bear Paw Rd
Ellisville, IL 61431-9567 - Phone
- (309) 253-3219
- NPI assigned
- Dec 7, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151029000730 | IL | Practitioner - Nurse Practitioner | 2365751526 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Psychiatric/Mental Health | Current |
Accepting new patients |
| Beth Psychiatry LLC | Psychiatric/Mental Health | Past | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 209007867 | IL | Yes |
Addresses
Primary practice location
7662 E Bear Paw Rd
Ellisville, IL 61431-9567
Mailing address
7662 E Bear Paw Rd
Ellisville, IL 61431-9567
Phone (309) 253-3219
Other names
- Julie Kay Kem
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.