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NPI Code Detail

MEDICARE: DENISE NUNEZ DO

MEDICARE: DENISE NUNEZ DO
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
1390200000XStudent in an Organized Health Care Education/Training Program125.083636IL

General Provider Information

NPI Number : 1639918352
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE NUNEZ DO
Provider Business Mailing Address
First Line : 4421 N ROCKWELL ST APT 2E
Second Line :
City : CHICAGO
State : IL
Zip : 60625-3039
Country : US
Telephone Number : 480-286-4855
Fax Number :
Provider Business Practice Location Address
First Line : 1901 W HARRISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3714
Country : US
Telephone Number : 312-864-7311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2024
Last Update Date : 05/22/2024

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