Healthcare Provider Details

I. General information

NPI: 1629818034
Provider Name (Legal Business Name): MARLEN SAENZ-SILVA RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2024
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6430 N CENTRAL AVE
CHICAGO IL
60646-2925
US

IV. Provider business mailing address

2837 N MERRIMAC AVE
CHICAGO IL
60634-5008
US

V. Phone/Fax

Practice location:
  • Phone: 312-806-7937
  • Fax:
Mailing address:
  • Phone: 312-934-6219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-316575
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: