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NPI Code Detail

MEDICARE: MS. VERONICA E. MORENO LMT, CMTPT

MEDICARE:  MS. VERONICA E. MORENO  LMT, CMTPT
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
1225700000XMassage Therapist227006002IL
2225500000XRespiratory/Developmental/Rehabilitative Specialist/Technologist227006002IL

General Provider Information

NPI Number : 1790800043
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VERONICA E. MORENO LMT, CMTPT
Provider Business Mailing Address
First Line : 1628 N SAWYER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-4915
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4332 N ELSTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2144
Country : US
Telephone Number : 773-604-5321
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 08/05/2009

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Directions to “ MS. VERONICA E. MORENO LMT, CMTPT” Practice Location

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