Healthcare Provider Details

I. General information

NPI: 1124527593
Provider Name (Legal Business Name): ADAM-JON APARICIO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2018
Last Update Date: 08/18/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5603 N WAYNE AVE APT 3
CHICAGO IL
60660
US

IV. Provider business mailing address

1055 W BRYN MAWR AVE STE F #274
CHICAGO IL
60660
US

V. Phone/Fax

Practice location:
  • Phone: 970-239-1983
  • Fax:
Mailing address:
  • Phone: 970-239-1983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: