Healthcare Provider Details

I. General information

NPI: 1386165413
Provider Name (Legal Business Name): MARIA P MALOTO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. MARIA ISABEL P MALOTO

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 09/12/2025
Certification Date: 11/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S WASHINGTON ST STE 370
NAPERVILLE IL
60540-6788
US

IV. Provider business mailing address

640 S WASHINGTON ST STE 370
NAPERVILLE IL
60540-6788
US

V. Phone/Fax

Practice location:
  • Phone: 630-420-9500
  • Fax: 630-420-9502
Mailing address:
  • Phone: 630-420-9500
  • Fax: 630-420-9502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209.017081
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number277000618
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code163WS0121X
TaxonomyPlastic Surgery Registered Nurse
License Number041302717
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: