Healthcare Provider Details

I. General information

NPI: 1427442185
Provider Name (Legal Business Name): ANA CRISTINA AGUILERA-ESTRADA RESPIRATORYTHERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2015
Last Update Date: 03/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 S AUSTIN BLVD
CICERO IL
60804-1604
US

IV. Provider business mailing address

1504 S AUSTIN BLVD
CICERO IL
60804-1604
US

V. Phone/Fax

Practice location:
  • Phone: 708-306-0149
  • Fax:
Mailing address:
  • Phone: 708-306-0149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number194.009716
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: