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NPI Code Detail

MEDICARE: MISS REBECCA MARIE BURKE

MEDICARE: MISS REBECCA MARIE BURKE
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

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902230279
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS REBECCA MARIE BURKE
Provider Business Mailing Address
First Line : 1048 W DICKENS AVE
Second Line : APARTMENT #23
City : CHICAGO
State : IL
Zip : 60614-4189
Country : US
Telephone Number : 817-366-2570
Fax Number :
Provider Business Practice Location Address
First Line : 8333 AUSTIN AVE
Second Line :
City : BURBANK
State : IL
Zip : 60459-2558
Country : US
Telephone Number : 708-398-6550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2013
Last Update Date : 08/22/2013

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Directions to “ MISS REBECCA MARIE BURKE ” Practice Location

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