MEDICARE: RICHARD MENDOZA MA

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

General Provider Information

NPI Number	:	1275323370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD MENDOZA MA

Provider Business Mailing Address
First Line	:	4953 N BELL AVE APT 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-6849
Country	:	US
Telephone Number	:	562-833-1243
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 W BRADLEY PL STE 100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-4716
Country	:	US
Telephone Number	:	877-552-6672
Fax Number	:

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

Provider Enumeration Date	:	05/12/2025
Last Update Date	:	03/11/2026

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Directions to “ RICHARD MENDOZA MA” Practice Location

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