Healthcare Provider Details

I. General information

NPI: 1588530372
Provider Name (Legal Business Name): HAYATT HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 CHATHAM RD STE R
SPRINGFIELD IL
62704-4188
US

IV. Provider business mailing address

1122 69TH ST
DARIEN IL
60561-3867
US

V. Phone/Fax

Practice location:
  • Phone: 561-777-0191
  • Fax:
Mailing address:
  • Phone: 561-777-0191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NANCY ALIAN
Title or Position: FAMILY NURSE PRACTITONER/OWNER
Credential: APRN
Phone: 561-777-0191