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NPI Code Detail

MEDICARE: MARIELA AGUILERA ED.D.

MEDICARE: MARIELA AGUILERA ED.D.
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
2103TS0200XSchool Psychologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12354912OTHERILISBE

General Provider Information

NPI Number : 1386019487
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIELA AGUILERA ED.D.
Provider Business Mailing Address
First Line : 42 W MADISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60602-4309
Country : US
Telephone Number : 773-553-1800
Fax Number :
Provider Business Practice Location Address
First Line : 42 W MADISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60602-4309
Country : US
Telephone Number : 773-553-1800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2015
Last Update Date : 11/15/2021

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Directions to “ MARIELA AGUILERA ED.D.” Practice Location

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