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General NPI Number Information
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NPI Number | 1861654709
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Entity Type | Organization
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Legal Business Name | HAYNES CHIROPRACTIC INC
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 4526 N LINCOLN AVE
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City | CHICAGO
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State | IL
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Zip | 60625-2103
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Country | US
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Telephone | 773-562-1392
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Fax |
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Provider Business Mailing Address
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Address Line | 4526 N LINCOLN AVE
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City | CHICAGO
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State | IL
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Zip | 60625-2103
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Country | US
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Telephone | 773-562-1392
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY M HAYNES
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Credential | D.C.
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Telephone | 312-658-0658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038010533
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License Number State | IL
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