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NPI Code Detail

MEDICARE: MADELINE VAZQUEZ

MEDICARE: MADELINE VAZQUEZ
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
1106S00000XBehavior TechnicianRBT-23-290242TX

General Provider Information

NPI Number : 1700662947
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE VAZQUEZ
Provider Business Mailing Address
First Line : 991 OAK CREEK DR
Second Line :
City : LOMBARD
State : IL
Zip : 60148-6408
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 700 N SAINT MARYS ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78205-3507
Country : US
Telephone Number : 847-465-9556
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2023
Last Update Date : 09/05/2023

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Directions to “ MADELINE VAZQUEZ ” Practice Location

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