Healthcare Provider Details

I. General information

NPI: 1306752068
Provider Name (Legal Business Name): HAYLEY ERICA ANDERSON OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1238 N LAKE ST
AURORA IL
60506-2453
US

IV. Provider business mailing address

448 RAINTREE CT UNIT 1F
GLEN ELLYN IL
60137-6756
US

V. Phone/Fax

Practice location:
  • Phone: 630-806-7220
  • Fax:
Mailing address:
  • Phone: 720-270-1478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046.012153
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: