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NPI Code Detail

MEDICARE: NATALIE C DIAZ

MEDICARE: NATALIE C DIAZ
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1851668164
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATALIE C DIAZ
Provider Business Mailing Address
First Line : 3309 N OCONTO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60634-3536
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3100 S CENTRAL AVE
Second Line :
City : CICERO
State : IL
Zip : 60804-3956
Country : US
Telephone Number : 708-863-3803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2011
Last Update Date : 06/06/2017

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Directions to “ NATALIE C DIAZ ” Practice Location

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