Healthcare Provider Details

I. General information

NPI: 1083554778
Provider Name (Legal Business Name): DENISSE MORALES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DENISSE MORALES BANDA

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4710 ARBOR DR APT 212
ROLLING MEADOWS IL
60008-4425
US

IV. Provider business mailing address

4710 ARBOR DR
ROLLING MEADOWS IL
60008-4406
US

V. Phone/Fax

Practice location:
  • Phone: 630-888-1443
  • Fax:
Mailing address:
  • Phone: 630-888-1443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: