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NPI Code Detail

MEDICARE: ALTANGEREL G BAILEY

MEDICARE: ALTANGEREL G BAILEY
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 Technician

General Provider Information

NPI Number : 1821639584
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALTANGEREL G BAILEY
Provider Business Mailing Address
First Line : 306 N KENSINGTON AVE
Second Line :
City : LA GRANGE PARK
State : IL
Zip : 60526-1870
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5408 NE 29TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97211-6244
Country : US
Telephone Number : 213-364-3532
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2019
Last Update Date : 02/27/2020

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Directions to “ ALTANGEREL G BAILEY ” Practice Location

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