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NPI Code Detail

MEDICARE: TATIANNA QUEZADA

MEDICARE: TATIANNA QUEZADA
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1295679801
Entity Type Code : Individual
Provider Name (Legal Business Name) : TATIANNA QUEZADA
Provider Business Mailing Address
First Line : 240 E HURON ST STE 1-200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2909
Country : US
Telephone Number : 312-503-1851
Fax Number :
Provider Business Practice Location Address
First Line : 240 E HURON ST STE 1-200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2909
Country : US
Telephone Number : 312-503-1851
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2026
Last Update Date : 04/15/2026

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Directions to “ TATIANNA QUEZADA ” Practice Location

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