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NPI Code Detail

MEDICARE: MRS. MARILOU VALENCIA HART R.N.

MEDICARE: MRS. MARILOU VALENCIA HART R.N.
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
1163WH0200XHome Health Registered NurseIL

General Provider Information

NPI Number : 1427270206
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARILOU VALENCIA HART R.N.
Provider Business Mailing Address
First Line : 6450 W BERTEAU AVE
Second Line : UNIT 513
City : CHICAGO
State : IL
Zip : 60634-6242
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6801 W HIGGINS AVE
Second Line : SUITE C
City : CHICAGO
State : IL
Zip : 60656-2009
Country : US
Telephone Number : 773-774-5460
Fax Number : 773-774-5461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 07/08/2007

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