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NPI Code Detail

MEDICARE: RAQUEL MARIE SEGOVIA

MEDICARE: RAQUEL MARIE SEGOVIA
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
11041C0700XClinical Social Worker150.109331IL

General Provider Information

NPI Number : 1386424224
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAQUEL MARIE SEGOVIA
Provider Business Mailing Address
First Line : 6321 N AVONDALE AVE STE 204
Second Line :
City : CHICAGO
State : IL
Zip : 60631-1961
Country : US
Telephone Number : 773-774-4444
Fax Number : 773-774-4447
Provider Business Practice Location Address
First Line : 6321 N AVONDALE AVE STE 204
Second Line :
City : CHICAGO
State : IL
Zip : 60631-1961
Country : US
Telephone Number : 773-774-4444
Fax Number : 773-774-4447
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2023
Last Update Date : 09/28/2023

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Directions to “ RAQUEL MARIE SEGOVIA ” Practice Location

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