Provider Demographics
NPI:1376972091
Name:MOJICA-CASTILLO, SYLVIA
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:
Last Name:MOJICA-CASTILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SYLVIA
Other - Middle Name:
Other - Last Name:MOJICA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:6015 N KILPATRICK AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5815
Mailing Address - Country:US
Mailing Address - Phone:773-919-6022
Mailing Address - Fax:773-736-7397
Practice Address - Street 1:6015 N KILPATRICK AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-5815
Practice Address - Country:US
Practice Address - Phone:773-919-6022
Practice Address - Fax:773-736-7397
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490048461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical