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NPI Code Detail

MEDICARE: GERARDO ASCENCIO

MEDICARE:   GERARDO  ASCENCIO
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
1174H00000XHealth EducatorIL

General Provider Information

NPI Number : 1346180171
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERARDO ASCENCIO
Provider Business Mailing Address
First Line : 5359 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1450
Country : US
Telephone Number : 773-295-3649
Fax Number :
Provider Business Practice Location Address
First Line : 5359 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1450
Country : US
Telephone Number : 773-295-3649
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2026
Last Update Date : 03/31/2026

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Directions to “ GERARDO ASCENCIO ” Practice Location

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