MEDICARE: MR. NATHAN ALCAZAR MS, BCBA

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	103K00000X	Behavior Analyst	1-22-57743	IL

General Provider Information

NPI Number	:	1346996105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NATHAN ALCAZAR MS, BCBA

Provider Business Mailing Address
First Line	:	8609 W BRYN MAWR AVE STE 204
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-3524
Country	:	US
Telephone Number	:	224-218-5365
Fax Number	:	223-241-3132

Provider Business Practice Location Address
First Line	:	814 N FRANKLIN ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60610-3813
Country	:	US
Telephone Number	:	224-218-5365
Fax Number	:

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

Provider Enumeration Date	:	03/01/2022
Last Update Date	:	01/16/2025

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