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NPI Code Detail

MEDICARE: MADELINE ROSE CARMONA

MEDICARE: MADELINE ROSE CARMONA
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 : 1831777697
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE ROSE CARMONA
Provider Business Mailing Address
First Line : 5731 S KILBOURN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60629-4811
Country : US
Telephone Number : 773-791-0653
Fax Number :
Provider Business Practice Location Address
First Line : 5731 S KILBOURN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60629-4811
Country : US
Telephone Number : 773-791-0653
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2021
Last Update Date : 03/31/2021

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Directions to “ MADELINE ROSE CARMONA ” 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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