MEDICARE: NAHARA ABIGAIL ESCALANTE BUSTILLO

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	104100000X	Social Worker	16764175	IL

General Provider Information

NPI Number	:	1134077951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAHARA ABIGAIL ESCALANTE BUSTILLO

Provider Business Mailing Address
First Line	:	445 PARK AVE STE A&C
Second Line	:
City	:	CARY
State	:	IL
Zip	:	60013-2752
Country	:	US
Telephone Number	:	224-699-3888
Fax Number	:

Provider Business Practice Location Address
First Line	:	445 PARK AVE STE A&C
Second Line	:
City	:	CARY
State	:	IL
Zip	:	60013-2752
Country	:	US
Telephone Number	:	224-699-3888
Fax Number	:

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

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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Directions to “ NAHARA ABIGAIL ESCALANTE BUSTILLO ” Practice Location

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