Provider Demographics
NPI:1285252478
Name:KHAYR, LAYLA
Entity type:Individual
Prefix:
First Name:LAYLA
Middle Name:
Last Name:KHAYR
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 1:588 HADDON CIR
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-2945
Mailing Address - Country:US
Mailing Address - Phone:847-212-5718
Mailing Address - Fax:
Practice Address - Street 1:1240 LEFORGE RD APT P8
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-3536
Practice Address - Country:US
Practice Address - Phone:847-212-5718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490177381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical