Individual
MERCEDES BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
1014 S OAKLEY BLVD, CHICAGO, IL 60612-4313
(312) 375-4151
Mailing address
1014 S OAKLEY BLVD, CHICAGO, IL 60612-4313
(312) 375-4151
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
11/11/2022
Last updated
11/11/2022
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