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General NPI Number Information
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NPI Number | 1194233080
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Entity Type | Individual
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Provider Name | AGNES DE LAS MERCEDES SALICHS ED.D
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Gender | Female
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Dates
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Enumeration Date | 01/13/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1804 IRVING PARK RD STE A
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City | HANOVER PARK
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State | IL
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Zip | 60133-3254
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Country | US
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Telephone | 773-965-1220
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Fax | 630-839-9024
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Provider Business Mailing Address
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Address Line | 1109 YORKSHIRE CT APT B
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City | ELGIN
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State | IL
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Zip | 60120-7115
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Country | US
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Telephone | 787-486-2425
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Fax | 630-839-9024
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 176
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License Number State | PR
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