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General NPI Number Information
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NPI Number | 1992303887
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Entity Type | Individual
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Provider Name | SIMONE PAES
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Gender | Female
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Dates
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Enumeration Date | 10/13/2020
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 3141 N SHEFFIELD AVE
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City | CHICAGO
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State | IL
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Zip | 60657
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Country | US
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Telephone | 713-992-9894
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Fax |
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Provider Business Mailing Address
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Address Line | 6540 N LINCOLN AVE STE 200
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City | LINCOLNWOOD
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State | IL
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Zip | 60712-3927
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Country | US
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Telephone |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-22-58770
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License Number State | IL
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