MEDICARE: HAYNES CHIROPRACTIC INC

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
1	111N00000X	Chiropractor	038010533	IL

General Provider Information

NPI Number	:	1861654709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAYNES CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	4526 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-2103
Country	:	US
Telephone Number	:	773-562-1392
Fax Number	:

Provider Business Practice Location Address
First Line	:	4526 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-2103
Country	:	US
Telephone Number	:	773-562-1392
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JEFFREY M HAYNES
Credential	:	D.C.
Telephone Number	:	312-658-0658

Provider Enumeration Date	:	07/01/2008
Last Update Date	:	05/22/2025

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