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NPI Code Detail

MEDICARE: RUBY ZARAGOZA

MEDICARE: RUBY ZARAGOZA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2106H00000XMarriage & Family Therapist
3101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1114474087
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUBY ZARAGOZA
Provider Business Mailing Address
First Line : 4916 S KEELER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60632-4515
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4001 N WOLCOTT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2411
Country : US
Telephone Number : 773-789-9775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2016
Last Update Date : 05/04/2024

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Directions to “ RUBY ZARAGOZA ” Practice Location

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