Provider Demographics
NPI:1386422202
Name:QUIROZ, ALMA LIZETH
Entity type:Individual
Prefix:
First Name:ALMA
Middle Name:LIZETH
Last Name:QUIROZ
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 1:432 W BRIARCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2819
Mailing Address - Country:US
Mailing Address - Phone:773-595-5273
Mailing Address - Fax:
Practice Address - Street 1:4071 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2117
Practice Address - Country:US
Practice Address - Phone:773-217-8571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health