Provider Demographics
NPI:1881825438
Name:GARCIA, KALEB
Entity Type:Individual
Prefix:MR
First Name:KALEB
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 N FARNSWORTH AVE
Mailing Address - Street 2:STE. 2H
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-2062
Mailing Address - Country:US
Mailing Address - Phone:866-596-4505
Mailing Address - Fax:866-596-4505
Practice Address - Street 1:1120 N FARNSWORTH AVE
Practice Address - Street 2:STE. 2H
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-2062
Practice Address - Country:US
Practice Address - Phone:866-596-4505
Practice Address - Fax:866-596-4505
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter