Provider Demographics
NPI:1447315429
Name:BAYLEY, RAYMOND II (DC)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:BAYLEY
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6448 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-2935
Mailing Address - Country:US
Mailing Address - Phone:773-774-9200
Mailing Address - Fax:773-774-6589
Practice Address - Street 1:6448 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-2935
Practice Address - Country:US
Practice Address - Phone:773-774-9200
Practice Address - Fax:773-774-6589
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-004912111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1618591OtherBCBS