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NPI Code Detail

MEDICARE: RETIA PATTON

MEDICARE: RETIA PATTON
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 Technician

General Provider Information

NPI Number : 1790672616
Entity Type Code : Individual
Provider Name (Legal Business Name) : RETIA PATTON
Provider Business Mailing Address
First Line : 8406 S VERNON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60619-6017
Country : US
Telephone Number : 773-501-3063
Fax Number :
Provider Business Practice Location Address
First Line : 8700 S DANTE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60619-7118
Country : US
Telephone Number : 773-346-7260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2025
Last Update Date : 06/23/2025

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Directions to “ RETIA PATTON ” Practice Location

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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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