MEDICARE: TANYA SALAZAR LPC, ATR

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	101YP2500X	Professional Counselor	178.021610	IL

General Provider Information

NPI Number	:	1508757048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANYA SALAZAR LPC, ATR

Provider Business Mailing Address
First Line	:	1526 W EDGEWATER AVE APT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-4211
Country	:	US
Telephone Number	:	630-210-2576
Fax Number	:

Provider Business Practice Location Address
First Line	:	1628 W MONTROSE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-1214
Country	:	US
Telephone Number	:	773-654-1865
Fax Number	:

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

Provider Enumeration Date	:	07/12/2025
Last Update Date	:	07/12/2025

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