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NPI Code Detail

MEDICARE: MACIEL ROA

MEDICARE: MACIEL ROA
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
1106S00000XBehavior TechnicianBACB829782IL

General Provider Information

NPI Number : 1659072387
Entity Type Code : Individual
Provider Name (Legal Business Name) : MACIEL ROA
Provider Business Mailing Address
First Line : 814 COMMERCE DR STE 100
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-8822
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 814 COMMERCE DR STE 100
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-8822
Country : US
Telephone Number : 630-883-4983
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2023
Last Update Date : 03/10/2023

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Directions to “ MACIEL ROA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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