Healthcare Provider Details

I. General information

NPI: 1417865445
Provider Name (Legal Business Name): BETZAIDA ALAMO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5210 MAIN ST
SKOKIE IL
60077-2158
US

IV. Provider business mailing address

1049 N CENTRAL PARK AVE
CHICAGO IL
60651-3908
US

V. Phone/Fax

Practice location:
  • Phone: 847-425-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: