Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | IL | |
Y | 103TS0200X | School Psychologist | 1513849 | IL |
NPI | 1023298023 |
---|---|
Provider Name | Felix Caceres JR. |
First Address | Chicago, IL 60625-2112 |
Second Address | Chicago, IL 60625-2112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2007 |
Last Update Date | 07/11/2007 |