Provider Demographics
NPI:1215760483
Name:HAYS, TAREN KENDRICK (RN)
Entity type:Individual
Prefix:
First Name:TAREN
Middle Name:KENDRICK
Last Name:HAYS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3209 N LAKEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3215
Mailing Address - Country:US
Mailing Address - Phone:312-279-9981
Mailing Address - Fax:312-279-9981
Practice Address - Street 1:3209 N LAKEWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3215
Practice Address - Country:US
Practice Address - Phone:312-279-9981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209031244363LP0808X
IL041463678163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse