Healthcare Provider Details

I. General information

NPI: 1174441422
Provider Name (Legal Business Name): JOCELYNE SALGADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 W ADAMS ST
CHICAGO IL
60607-2801
US

IV. Provider business mailing address

1647 W 21ST PL
CHICAGO IL
60608-4403
US

V. Phone/Fax

Practice location:
  • Phone: 312-243-8487
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-440846
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: