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General NPI Number Information
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NPI Number | 1598498875
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Entity Type | Individual
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Provider Name | NAHIME GUADALUPE AGUIRRE MTANOUS LSW
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Gender | Female
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Dates
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Enumeration Date | 07/05/2022
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 3001 N SOUTHPORT AVE FL 2
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City | CHICAGO
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State | IL
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Zip | 60657-4289
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Country | US
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Telephone | 773-799-8966
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Fax |
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Provider Business Mailing Address
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Address Line | 1330 E 53RD ST APT 1321
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City | CHICAGO
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State | IL
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Zip | 60615-1070
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Country | US
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Telephone | 956-225-4735
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150109151
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License Number State | IL
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