Healthcare Provider Details

I. General information

NPI: 1184321663
Provider Name (Legal Business Name): LESLEY CRISTAL ARROYO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2023
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5406 W 26TH ST
CICERO IL
60804-3336
US

IV. Provider business mailing address

5406 W 26TH ST
CICERO IL
60804-3336
US

V. Phone/Fax

Practice location:
  • Phone: 708-830-4832
  • Fax:
Mailing address:
  • Phone: 708-830-4832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: