Individual
ANDREA NICOLE HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5425 W LAKE ST, CHICAGO, IL 60644-2342
(773) 378-3347
Mailing address
108 S WALLER AVE, CHICAGO, IL 60644
(601) 405-4674
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036156114
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2018
Last updated
04/16/2025
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