Provider Demographics
NPI:1922729854
Name:HAYES, KEISHA L
Entity Type:Individual
Prefix:MS
First Name:KEISHA
Middle Name:L
Last Name:HAYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10809 S KENNETH AVE
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-5724
Mailing Address - Country:US
Mailing Address - Phone:773-647-5654
Mailing Address - Fax:
Practice Address - Street 1:8 S MICHIGAN AVE STE 2300
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-3330
Practice Address - Country:US
Practice Address - Phone:773-980-9499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist