Provider Demographics
NPI:1295433571
Name:HAYES, SHANELL (CNA)
Entity type:Individual
Prefix:
First Name:SHANELL
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 N HAMLIN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60651-3841
Mailing Address - Country:US
Mailing Address - Phone:773-971-2319
Mailing Address - Fax:
Practice Address - Street 1:1130 N HAMLIN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60651-3841
Practice Address - Country:US
Practice Address - Phone:773-971-2319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)