Provider Demographics
NPI:1588820047
Name:SALCEDO, SANDRA F
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:F
Last Name:SALCEDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12546 FAIRVIEW AVE
Mailing Address - Street 2:UNIT 2D
Mailing Address - City:BLUE ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60406-1766
Mailing Address - Country:US
Mailing Address - Phone:708-388-0699
Mailing Address - Fax:
Practice Address - Street 1:12546 FAIRVIEW AVE
Practice Address - Street 2:UNIT 2D
Practice Address - City:BLUE ISLAND
Practice Address - State:IL
Practice Address - Zip Code:60406-1766
Practice Address - Country:US
Practice Address - Phone:708-388-0699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter