DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MR. HAYDEN MAXWELL GORR-DIAZ AM

MEDICARE: MR. HAYDEN MAXWELL GORR-DIAZ AM
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
11041C0700XClinical Social WorkerIL

General Provider Information

NPI Number : 1700663341
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. HAYDEN MAXWELL GORR-DIAZ AM
Provider Business Mailing Address
First Line : 655 W IRVING PARK RD APT 308
Second Line :
City : CHICAGO
State : IL
Zip : 60613-3135
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1740 RIDGE AVE STE LL15A
Second Line :
City : EVANSTON
State : IL
Zip : 60201-5919
Country : US
Telephone Number : 312-656-2505
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2023
Last Update Date : 01/19/2026

Similar Medicare Providers

1194264663 — CARL HIPPENSTEEL
Practice Location Address:
1740 RIDGE AVE STE LL15A
EVANSTON, IL
60201-5919
Practice Phone: 312-778-5118
Practice Fax:
1972258820 — SUNFLOWER CLINICAL GROUP LTD
Practice Location Address:
1740 RIDGE AVE STE LL15A
EVANSTON, IL
60201-5919
Practice Phone: 773-569-2689
Practice Fax:
1922999606 — ANDREW UNRUE
Practice Location Address:
1740 RIDGE AVE STE LL15A
EVANSTON, IL
60201-5919
Practice Phone: 312-877-9411
Practice Fax:
1104717511 — DESTINEE NICOLE WELLS
Practice Location Address:
1740 RIDGE AVE STE LL15A
EVANSTON, IL
60201-5919
Practice Phone: 312-877-9411
Practice Fax:
1962386730 — SUNFLOWER CLINICAL GROUP LTD
Practice Location Address:
1740 RIDGE AVE STE LL15A
EVANSTON, IL
60201-5919
Practice Phone: 312-877-9411
Practice Fax:
1184117962 — KELSEY GALLO MD
Practice Location Address:
1000 CENTRAL ST STE 720
EVANSTON, IL
60201-1779
Practice Phone: 847-503-3000
Practice Fax: 847-503-3500

Directions to “ MR. HAYDEN MAXWELL GORR-DIAZ AM” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.