Provider Demographics
NPI:1144202748
Name:HAYEK, RICHARD
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:HAYEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 RAND RD STE 300
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2359
Mailing Address - Country:US
Mailing Address - Phone:847-324-3976
Mailing Address - Fax:847-929-1154
Practice Address - Street 1:250 S NORTHWEST HWY STE 100
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-4237
Practice Address - Country:US
Practice Address - Phone:773-631-7898
Practice Address - Fax:773-631-3005
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-084446207X00000X
IL036084446207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036084446Medicaid
IL200012924OtherPTAN
IL0021604007OtherBSIL
IL1144202748OtherNPI
IL036084446Medicaid
131128300OtherUS DEPT OF LABOR
IL0242720001OtherDME
ILL50238Medicare UPIN
IL036084446Medicaid