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NPI Code Detail

MEDICARE: BLANCA MEDINA

MEDICARE: BLANCA MEDINA
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1811870645
Entity Type Code : Individual
Provider Name (Legal Business Name) : BLANCA MEDINA
Provider Business Mailing Address
First Line : 3062 E 91ST ST
Second Line :
City : CHICAGO
State : IL
Zip : 60617-4401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3062 E 91ST ST
Second Line :
City : CHICAGO
State : IL
Zip : 60617-4401
Country : US
Telephone Number : 773-999-5283
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2025
Last Update Date : 05/19/2026

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Directions to “ BLANCA MEDINA ” Practice Location

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