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NPI Code Detail

MEDICARE: DANIELA ULLOA

MEDICARE: DANIELA ULLOA
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
1106S00000XBehavior TechnicianBACB1041299IL

General Provider Information

NPI Number : 1396592838
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELA ULLOA
Provider Business Mailing Address
First Line : 522 W CHESTNUT ST STE GA
Second Line :
City : HINSDALE
State : IL
Zip : 60521-3174
Country : US
Telephone Number : 331-271-5070
Fax Number : 331-271-5071
Provider Business Practice Location Address
First Line : 522 W CHESTNUT ST STE GA
Second Line :
City : HINSDALE
State : IL
Zip : 60521-3174
Country : US
Telephone Number : 331-271-5070
Fax Number : 331-271-5071
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2024
Last Update Date : 05/02/2024

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Directions to “ DANIELA ULLOA ” Practice Location

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