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NPI Code Detail

MEDICARE: JOE AIVAZ

MEDICARE:   JOE  AIVAZ
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1134750714
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOE AIVAZ
Provider Business Mailing Address
First Line : 3400 W STONEGATE BLVD STE 101-2109
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60005-1045
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3400 W STONEGATE BLVD STE 101-2109
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60005-1045
Country : US
Telephone Number : 331-241-6485
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2020
Last Update Date : 11/05/2023

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Directions to “ JOE AIVAZ ” Practice Location

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