Individual
LAURA ILEANA FERNANDEZ MORALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(787) 607-3392
Mailing address
215 W WASHINGTON ST APT 2307, CHICAGO, IL 60606-3509
(787) 607-3392
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125081019
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2021
Last updated
06/24/2022
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