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NPI Code Detail

MEDICARE: MISS MALENA LIVERA CARRANZA

MEDICARE: MISS MALENA LIVERA CARRANZA
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
1222Q00000XDevelopmental Therapist222Q00000XIL

General Provider Information

NPI Number : 1770446080
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MALENA LIVERA CARRANZA
Provider Business Mailing Address
First Line : 2336 W 21ST ST
Second Line :
City : CHICAGO
State : IL
Zip : 60608-5055
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4101 LIBERTY BLVD APT 1
Second Line :
City : WESTMONT
State : IL
Zip : 60559-1348
Country : US
Telephone Number : 630-426-9386
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2025
Last Update Date : 12/04/2025

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1023801602 — MADELINE KOWALSKI
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Directions to “ MISS MALENA LIVERA CARRANZA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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