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NPI Code Detail

MEDICARE: STEPHANIE LIZBETH VALDEZ

MEDICARE: STEPHANIE LIZBETH VALDEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1073405734
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE LIZBETH VALDEZ
Provider Business Mailing Address
First Line : 7228 CIRCLE AVE
Second Line :
City : FOREST PARK
State : IL
Zip : 60130-1163
Country : US
Telephone Number : 630-632-4350
Fax Number :
Provider Business Practice Location Address
First Line : 7228 CIRCLE AVE
Second Line :
City : FOREST PARK
State : IL
Zip : 60130-1163
Country : US
Telephone Number : 630-632-4350
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2025
Last Update Date : 07/17/2025

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Directions to “ STEPHANIE LIZBETH VALDEZ ” Practice Location

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