Healthcare Provider Details

I. General information

NPI: 1396548459
Provider Name (Legal Business Name): CECILIA IRENE NATERAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3443 S LOMBARD AVE
CICERO IL
60804-3704
US

IV. Provider business mailing address

3443 S LOMBARD AVE
CICERO IL
60804-3704
US

V. Phone/Fax

Practice location:
  • Phone: 708-334-3270
  • Fax:
Mailing address:
  • Phone: 708-334-3270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150118642
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: