Healthcare Provider Details

I. General information

NPI: 1265257042
Provider Name (Legal Business Name): ANABEL ESCOBEDO MERAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1752 CAPITAL ST
ELGIN IL
60124-7896
US

IV. Provider business mailing address

110 LAKE DR
LAKE IN THE HILLS IL
60156-1326
US

V. Phone/Fax

Practice location:
  • Phone: 847-695-3680
  • Fax:
Mailing address:
  • Phone: 224-605-7512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: