Provider Demographics
NPI:1174396808
Name:ALCARAZ, OSVALDO
Entity type:Individual
Prefix:
First Name:OSVALDO
Middle Name:
Last Name:ALCARAZ
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 1:1340 SHERMER RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4598
Mailing Address - Country:US
Mailing Address - Phone:312-620-0217
Mailing Address - Fax:
Practice Address - Street 1:1340 SHERMER RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4598
Practice Address - Country:US
Practice Address - Phone:312-620-0217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health