Healthcare Provider Details

I. General information

NPI: 1679626717
Provider Name (Legal Business Name): ISTINA MORARIU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N RIVER RD
DES PLAINES IL
60016-1209
US

IV. Provider business mailing address

5330 W DEVON AVE STE. #14
CHICAGO IL
60646-4108
US

V. Phone/Fax

Practice location:
  • Phone: 847-297-1800
  • Fax:
Mailing address:
  • Phone: 312-505-0938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number036-097205
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: