MEDICARE: TYKISHA BAYS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	32050	IL
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1881059962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYKISHA BAYS

Provider Business Mailing Address
First Line	:	410 S MICHIGAN AVE STE 920
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-1399
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 S MICHIGAN AVE STE 920
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-1399
Country	:	US
Telephone Number	:	312-248-3190
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2015
Last Update Date	:	10/27/2022

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Directions to “ TYKISHA BAYS ” Practice Location

Language	Start Address	Practice Location

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