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1245885474
MIGUEL BAUTISTA
CHICAGO, IL
NPI
1245885474
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: 31818)
Enumeration Date
2019-08-05
Last Update Date
2019-08-05
Business Address
MIGUEL BAUTISTA CADC
4259 S BERKELEY AVE
CHICAGO, IL 60653-3030
Phone number: 773-268-7600
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Mailing Address
MIGUEL BAUTISTA CADC
4259 S BERKELEY AVE
CHICAGO, IL 60653-3030
Phone number:
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