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NPI Code Detail

MEDICARE: JACQUELYN ARMENTA

MEDICARE: JACQUELYN ARMENTA
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 TechnicianIL

General Provider Information

NPI Number : 1710818802
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELYN ARMENTA
Provider Business Mailing Address
First Line : 520 S LINCOLN AVE
Second Line :
City : WAUKEGAN
State : IL
Zip : 60085-6304
Country : US
Telephone Number : 847-604-0955
Fax Number :
Provider Business Practice Location Address
First Line : 105 N GREENLEAF ST STE B
Second Line :
City : GURNEE
State : IL
Zip : 60031-3326
Country : US
Telephone Number : 847-604-0955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2026
Last Update Date : 05/27/2026

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Directions to “ JACQUELYN ARMENTA ” Practice Location

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