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NPI Code Detail

MEDICARE: DR. LOUIS V HAYNES PSY.D.

MEDICARE: DR. LOUIS V HAYNES PSY.D.
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
1103TC0700XClinical Psychologist071.009790IL

General Provider Information

NPI Number : 1942578190
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOUIS V HAYNES PSY.D.
Provider Business Mailing Address
First Line : 2732 N CLARK ST STE 300
Second Line :
City : CHICAGO
State : IL
Zip : 60614-1553
Country : US
Telephone Number : 708-381-9352
Fax Number :
Provider Business Practice Location Address
First Line : 2732 N CLARK ST STE 300
Second Line :
City : CHICAGO
State : IL
Zip : 60614-1553
Country : US
Telephone Number : 708-381-9352
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2011
Last Update Date : 06/05/2025

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