MEDICARE: DR. VALENTINA MARIE PACHECO-CORNEJO PSY.D.

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	103TC0700X	Clinical Psychologist	071009585	IL

General Provider Information

NPI Number	:	1124453394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VALENTINA MARIE PACHECO-CORNEJO PSY.D.

Provider Business Mailing Address
First Line	:	6011 S MENARD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60638-4419
Country	:	US
Telephone Number	:	773-431-0486
Fax Number	:

Provider Business Practice Location Address
First Line	:	11848 S WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-4734
Country	:	US
Telephone Number	:	773-431-0486
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2013
Last Update Date	:	07/14/2025

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