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NPI Code Detail

MEDICARE: MR. LUIS FIGUEROA JR.

MEDICARE: MR. LUIS FIGUEROA JR.
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
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1407579691
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LUIS FIGUEROA JR.
Provider Business Mailing Address
First Line : 2206 EASTLAND DR STE 101
Second Line :
City : BLOOMINGTON
State : IL
Zip : 61704-7742
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2206 EASTLAND DR STE 101
Second Line :
City : BLOOMINGTON
State : IL
Zip : 61704-7742
Country : US
Telephone Number : 815-690-3576
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2022
Last Update Date : 09/22/2022

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Directions to “ MR. LUIS FIGUEROA JR. ” Practice Location

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