Provider Demographics
NPI:1700680287
Name:PINEDA, AHLELI
Entity type:Individual
Prefix:
First Name:AHLELI
Middle Name:
Last Name:PINEDA
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 S LOWE AVE # 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-3421
Mailing Address - Country:US
Mailing Address - Phone:312-890-6030
Mailing Address - Fax:
Practice Address - Street 1:4225 W 25TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-3638
Practice Address - Country:US
Practice Address - Phone:773-542-7617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health