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NPI Code Detail

MEDICARE: BLAIR J HAYES RDN, LDN

MEDICARE:   BLAIR J HAYES  RDN, LDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian164.008089IL

General Provider Information

NPI Number : 1356953004
Entity Type Code : Individual
Provider Name (Legal Business Name) : BLAIR J HAYES RDN, LDN
Provider Business Mailing Address
First Line : 1 E ERIE ST STE 525
Second Line : #227
City : CHICAGO
State : IL
Zip : 60611-2980
Country : US
Telephone Number : 224-357-6599
Fax Number :
Provider Business Practice Location Address
First Line : 1 E ERIE ST STE 525
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2980
Country : US
Telephone Number : 224-357-6599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2020
Last Update Date : 09/22/2020

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