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General NPI Number Information
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NPI Number | 1154443307
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Entity Type | Individual
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Provider Name | LETTICIA ALVAREZ M.ED.
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Gender | Female
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11044 S. AVENUE F
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City | CHICAGO
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State | IL
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Zip | 60617
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Country | US
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Telephone | 773-480-1420
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Fax | 773-356-6500
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Provider Business Mailing Address
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Address Line | PO BOX 170112
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City | CHICAGO
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State | IL
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Zip | 60617-9112
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Country | US
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Telephone | 773-480-1420
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Fax | 773-356-6500
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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