MEDICARE: ANTONIA PAEZ

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	171R00000X	Interpreter

General Provider Information

NPI Number	:	1255519724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTONIA PAEZ

Provider Business Mailing Address
First Line	:	1938 W 21ST PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-4202
Country	:	US
Telephone Number	:	773-732-0894
Fax Number	:

Provider Business Practice Location Address
First Line	:	1938 W 21ST PLACE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-4202
Country	:	US
Telephone Number	:	773-732-0894
Fax Number	:

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

Provider Enumeration Date	:	02/06/2008
Last Update Date	:	02/06/2008

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Directions to “ ANTONIA PAEZ ” Practice Location

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