MEDICARE: KARINA VARGAS GARCES

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	222Q00000X	Developmental Therapist		IL

General Provider Information

NPI Number	:	1710721600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARINA VARGAS GARCES

Provider Business Mailing Address
First Line	:	1656 GREENWOOD RD APT F
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-1577
Country	:	US
Telephone Number	:	224-392-0605
Fax Number	:

Provider Business Practice Location Address
First Line	:	258 MARSEILLES ST
Second Line	:
City	:	VERNON HILLS
State	:	IL
Zip	:	60061-4147
Country	:	US
Telephone Number	:	847-702-1542
Fax Number	:

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

Provider Enumeration Date	:	06/24/2024
Last Update Date	:	06/25/2024

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