MEDICARE: VERONICA FLORES ZAPATA

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
1	101YP2500X	Professional Counselor	178014146	IL

General Provider Information

NPI Number	:	1962070011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA FLORES ZAPATA

Provider Business Mailing Address
First Line	:	1841 S CALUMET AVE APT 1107
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-4812
Country	:	US
Telephone Number	:	773-332-7715
Fax Number	:

Provider Business Practice Location Address
First Line	:	4507 N RAVENSWOOD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5218
Country	:	US
Telephone Number	:	773-850-0900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2021
Last Update Date	:	06/15/2021

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