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NPI Code Detail

MEDICARE: MRS. EVA ASTACIO RDH

MEDICARE: MRS. EVA ASTACIO RDH
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
1124Q00000XDental Hygienist020.017876IL

General Provider Information

NPI Number : 1720849995
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EVA ASTACIO RDH
Provider Business Mailing Address
First Line : 947 N LATROBE AVE FL 2
Second Line :
City : CHICAGO
State : IL
Zip : 60651-2962
Country : US
Telephone Number : 872-305-7954
Fax Number :
Provider Business Practice Location Address
First Line : 1520 N KOSTNER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60651-1610
Country : US
Telephone Number : 312-216-8020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2024
Last Update Date : 01/16/2024

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Directions to “ MRS. EVA ASTACIO RDH” Practice Location

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