MEDICARE: CINDIA QUINONES

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
1	222Q00000X	Developmental Therapist		IL

General Provider Information

NPI Number	:	1194846766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDIA QUINONES

Provider Business Mailing Address
First Line	:	PO BOX 410534
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-0534
Country	:	US
Telephone Number	:	773-817-2074
Fax Number	:	773-478-4599

Provider Business Practice Location Address
First Line	:	2957 N KEDZIE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-7603
Country	:	US
Telephone Number	:	773-817-2074
Fax Number	:	773-478-4599

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	07/08/2007

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Directions to “ CINDIA QUINONES ” Practice Location

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