Individual
MARIA MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 RIDGE AVE STE G320, EVANSTON, IL 60201-2716
(847) 866-2977
Mailing address
2100 RIDGE AVE STE G320, EVANSTON, IL 60201-2716
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041176919
IL
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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