Individual provider Active NPI

Tjuana Haywood

  • Registered Nurse
  • Chicago, IL
National Provider Identifier
1609664465
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041424557 Issued in IL
Practice address
7725 S Calumet Ave
Chicago, IL 60619-2926
Phone
(773) 251-0624
Fax
(773) 251-0624
NPI assigned
Apr 30, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041424557 IL Primary

Addresses

Primary practice location

7725 S Calumet Ave
Chicago, IL 60619-2926

Mailing address

7725 S Calumet Ave
Chicago, IL 60619-2926
Phone (773) 251-0624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
041424557ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1745971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1609664465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7725 S CALUMET AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606192926",
            "telephone_number": "773-251-0624",
            "fax_number": "773-251-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7725 S CALUMET AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606192926",
            "telephone_number": "773-251-0624",
            "fax_number": "773-251-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYWOOD",
        "first_name": "TJUANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-30",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041424557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.