Healthcare Provider Details

I. General information

NPI: 1336063825
Provider Name (Legal Business Name): JENNIFER JEAN HAYES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 E DIEHL RD STE 123
NAPERVILLE IL
60563-4908
US

IV. Provider business mailing address

603 E DIEHL RD STE 123
NAPERVILLE IL
60563-4908
US

V. Phone/Fax

Practice location:
  • Phone: 708-792-0162
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-320712
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: