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General NPI Number Information
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NPI Number | 1154010353
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Entity Type | Individual
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Provider Name | MARINA AURELIO ESTRELLA FNP
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Gender | Female
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Dates
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Enumeration Date | 05/03/2023
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 2504 WASHINGTON ST STE 401C
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City | WAUKEGAN
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State | IL
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Zip | 60085-4960
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Country | US
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Telephone | 224-946-6859
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Fax | 224-298-0460
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Provider Business Mailing Address
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Address Line | 2504 WASHINGTON ST STE 401C
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City | WAUKEGAN
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State | IL
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Zip | 60085-4960
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Country | US
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Telephone | 224-946-6859
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209027706
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License Number State | IL
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