Colin M Haley, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

01927330 Issued in IL

Practice address

12200 Western Ave
Suite 108
Blue Island, IL 60406-1398

Phone

(708) 385-3700

Fax

(708) 385-3707

NPI assigned

Aug 15, 2007

Last updated

Aug 15, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chaley581444@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Howard Brown Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1306048632
  Medicare reassignment NPD
• Howard Brown Health Center

  dba Howard Brown Health at La Casa Norte

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1427523125
  NPD
• Dental Experts, LLC

  • General Practice Dentistry
  • Blue Island, IL
  • NPI 1154592145
  NPD (past)
• Howard Brown Health Center

  • Health Educator
  • Chicago, IL
  • NPI 1811824121
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1487846234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 W ERIE ST",
            "address_2": "STE 500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606106914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 WESTERN AVE",
            "address_2": "SUITE 108",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604061398",
            "telephone_number": "708-385-3700",
            "fax_number": "708-385-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "COLIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "01927330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guildhaus
• Guildhaus
• Anne Guinane, RD, LDN
• Latriese Guyton, R.N.
• H & H Transportation Service for the Aging Inc
• Jenay Harrington
• Ngozi Harris, LCPC
• Sheryl Harris
• Heads Over Hill's Salon & Cranial Prosthesis LLC
• George Fay Henry Jr., LCSW

• General Practice Dentistry in Blue Island, IL
• Providers in Blue Island, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.