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NPI Code Detail

MEDICARE: ALEJANDRA MORENO

MEDICARE: ALEJANDRA MORENO
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1407461734
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEJANDRA MORENO
Provider Business Mailing Address
First Line : 1400 S AUSTIN BLVD
Second Line :
City : CICERO
State : IL
Zip : 60804-1003
Country : US
Telephone Number : 312-330-8610
Fax Number :
Provider Business Practice Location Address
First Line : 1400 S AUSTIN BLVD
Second Line :
City : CICERO
State : IL
Zip : 60804-1003
Country : US
Telephone Number : 312-330-8610
Fax Number : 773-349-8083
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2020
Last Update Date : 09/14/2020

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Directions to “ ALEJANDRA MORENO ” Practice Location

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