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General NPI Number Information
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NPI Number | 1093203150
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Entity Type | Individual
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Provider Name | RICARDO E ESPINO
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Gender | Male
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Dates
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Enumeration Date | 04/24/2018
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Last Update Date | 04/24/2018
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Provider Practice Location Address
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Address Line | 8644 S 86TH AVE APT 113
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City | JUSTICE
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State | IL
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Zip | 60458-2113
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Country | US
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Telephone | 708-546-0806
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Fax |
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Provider Business Mailing Address
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Address Line | 3843 W 63RD ST
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City | CHICAGO
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State | IL
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Zip | 60629-4623
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Country | US
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Telephone | 773-884-2200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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