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General NPI Number Information
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NPI Number | 1043495401
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Entity Type | Organization
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Legal Business Name | DANIEL M. HAYCRAFT MD, PC
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Dates
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Enumeration Date | 01/04/2008
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Last Update Date | 01/04/2008
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Provider Practice Location Address
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Address Line | 5225 OLD ORCHARD RD SUITE 34
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City | SKOKIE
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State | IL
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Zip | 60077-4405
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Country | US
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Telephone | 847-581-1890
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Fax | 847-581-1895
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Provider Business Mailing Address
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Address Line | 5225 OLD ORCHARD RD SUITE 34
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City | SKOKIE
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State | IL
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Zip | 60077-4405
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Country | US
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Telephone | 847-581-1890
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Fax | 847-581-1895
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL M. HAYCRAFT
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Credential | MD
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Telephone | 847-581-1890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | IL
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