Provider Demographics
NPI:1114549680
Name:HAYLES, NAOMI
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:HAYLES
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 1:10522 S CICERO AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-5200
Mailing Address - Country:US
Mailing Address - Phone:708-885-9852
Mailing Address - Fax:
Practice Address - Street 1:10522 S CICERO AVE STE 100
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-5200
Practice Address - Country:US
Practice Address - Phone:708-885-9852
Practice Address - Fax:708-741-1545
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-07
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care