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NPI Code Detail

MEDICARE: ISIS AMAYA FLORES MA

MEDICARE: ISIS AMAYA FLORES MA
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1134964018
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISIS AMAYA FLORES MA
Provider Business Mailing Address
First Line : 94 N SAVANNAH PKWY
Second Line :
City : ROUND LAKE
State : IL
Zip : 60073-9579
Country : US
Telephone Number : 847-609-4560
Fax Number :
Provider Business Practice Location Address
First Line : 1811 W NORTH AVE STE 402
Second Line :
City : CHICAGO
State : IL
Zip : 60622-0204
Country : US
Telephone Number : 312-819-7381
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2024
Last Update Date : 07/01/2024

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