Provider Demographics
NPI:1144427378
Name:HAYES, COLIN M (MHP)
Entity Type:Individual
Prefix:MR
First Name:COLIN
Middle Name:M
Last Name:HAYES
Suffix:
Gender:M
Credentials:MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:POLO
Mailing Address - State:IL
Mailing Address - Zip Code:61064-1306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:555 FAIRVIEW DR
Practice Address - Street 2:OFFICE
Practice Address - City:ROCHELLE
Practice Address - State:IL
Practice Address - Zip Code:61068-2310
Practice Address - Country:US
Practice Address - Phone:815-561-9003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility