MEDICARE: VANESSA CARRERA

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
1	171R00000X	Interpreter

General Provider Information

NPI Number	:	1477852861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA CARRERA

Provider Business Mailing Address
First Line	:	1708 N 38TH AVE
Second Line	:
City	:	STONE PARK
State	:	IL
Zip	:	60165-1102
Country	:	US
Telephone Number	:	708-510-1384
Fax Number	:

Provider Business Practice Location Address
First Line	:	2942 ERNST ST
Second Line	:
City	:	FRANKLIN PARK
State	:	IL
Zip	:	60131-2402
Country	:	US
Telephone Number	:	708-510-1384
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2011
Last Update Date	:	03/24/2011

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Directions to “ VANESSA CARRERA ” Practice Location

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