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NPI Code Detail

MEDICARE: GUADALUPE MERCADO

MEDICARE:   GUADALUPE  MERCADO
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 Therapist

General Provider Information

NPI Number : 1932873346
Entity Type Code : Individual
Provider Name (Legal Business Name) : GUADALUPE MERCADO
Provider Business Mailing Address
First Line : 1111 W MADISON ST STE 2
Second Line :
City : CHICAGO
State : IL
Zip : 60607-2055
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1111 W MADISON ST STE 2
Second Line :
City : CHICAGO
State : IL
Zip : 60607-2055
Country : US
Telephone Number : 773-234-1042
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2021
Last Update Date : 08/09/2021

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Directions to “ GUADALUPE MERCADO ” Practice Location

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