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NPI Code Detail

MEDICARE: DENISE BURNS

MEDICARE: DENISE BURNS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1194344374
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE BURNS
Provider Business Mailing Address
First Line : 1222 W 95TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60643-1408
Country : US
Telephone Number : 773-238-5555
Fax Number :
Provider Business Practice Location Address
First Line : 1222 W 95TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60643-1408
Country : US
Telephone Number : 773-238-5555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2020
Last Update Date : 04/08/2020

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Directions to “ DENISE BURNS ” Practice Location

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