Basic Information
| Provider Information | |||||||||
| NPI: | 1891064101 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DI MEGLIO | ||||||||
| FirstName: | CHIARA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1409 W CARROLL AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606071105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3127330883 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1409 W CARROLL AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606071105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3127330883 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2011 | ||||||||
| LastUpdateDate: | 08/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 222Q00000X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist | 103K00000X | IL | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.