Provider Demographics
NPI:1417397258
Name:TORRES, JOVANA IRENE
Entity type:Individual
Prefix:
First Name:JOVANA
Middle Name:IRENE
Last Name:TORRES
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 1:2421 W MCLEAN AVE
Mailing Address - Street 2:APT. 1R
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-6827
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2421 W MCLEAN AVE
Practice Address - Street 2:APT. 1R
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-6827
Practice Address - Country:US
Practice Address - Phone:630-670-0953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst