Provider Demographics
NPI:1568065977
Name:ACUNA BORRELL, ZULIA (SA-C)
Entity Type:Individual
Prefix:
First Name:ZULIA
Middle Name:
Last Name:ACUNA BORRELL
Suffix:
Gender:F
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8665 GRAND AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:RIVER GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60171-1342
Mailing Address - Country:US
Mailing Address - Phone:773-633-7166
Mailing Address - Fax:
Practice Address - Street 1:8665 GRAND AVE APT 202
Practice Address - Street 2:
Practice Address - City:RIVER GROVE
Practice Address - State:IL
Practice Address - Zip Code:60171-1342
Practice Address - Country:US
Practice Address - Phone:773-633-7166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL20-438246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant