MEDICARE: FANNY KAREM ACUNA GARCIA

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	101YP2500X	Professional Counselor	178.021107	IL

General Provider Information

NPI Number	:	1205795333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FANNY KAREM ACUNA GARCIA

Provider Business Mailing Address
First Line	:	3058 W BELMONT AVE UNIT 2D
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-5707
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3058 W BELMONT AVE UNIT 2D
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-5707
Country	:	US
Telephone Number	:	312-725-4879
Fax Number	:

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

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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