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General NPI Number Information
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NPI Number | 1346996105
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Entity Type | Individual
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Provider Name | NATHAN ALCAZAR MS, BCBA
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Gender | Male
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Dates
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Enumeration Date | 03/01/2022
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 814 N FRANKLIN ST
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City | CHICAGO
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State | IL
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Zip | 60610-3813
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Country | US
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Telephone | 224-218-5365
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Fax |
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Provider Business Mailing Address
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Address Line | 8609 W BRYN MAWR AVE STE 204
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City | CHICAGO
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State | IL
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Zip | 60631-3524
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Country | US
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Telephone | 224-218-5365
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Fax | 223-241-3132
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-22-57743
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License Number State | IL
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