Healthcare Provider Details

I. General information

NPI: 1992689715
Provider Name (Legal Business Name): JORGE LUIS MORALES CARDONA ND
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 03/15/2026
Certification Date: 03/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8348 LEMONT RD
DARIEN IL
60561-1510
US

IV. Provider business mailing address

18W070 ROYCE BLVD
OAKBROOK TERRACE IL
60181-4880
US

V. Phone/Fax

Practice location:
  • Phone: 630-442-0169
  • Fax:
Mailing address:
  • Phone: 817-705-3144
  • Fax: 817-705-3144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number164023427
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: