MEDICARE: TERIAHNA MERCADO LEXI MERCADO

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	103K00000X	Behavior Analyst	BCAB915859	IL

General Provider Information

NPI Number	:	1144186776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERIAHNA MERCADO LEXI MERCADO

Provider Business Mailing Address
First Line	:	105 N GREENLEAF ST
Second Line	:
City	:	GURNEE
State	:	IL
Zip	:	60031-3326
Country	:	US
Telephone Number	:	847-376-9191
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 N GREENLEAF ST
Second Line	:
City	:	GURNEE
State	:	IL
Zip	:	60031-3326
Country	:	US
Telephone Number	:	630-465-3963
Fax Number	:

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

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	12/29/2025

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Directions to “ TERIAHNA MERCADO LEXI MERCADO ” Practice Location

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