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General NPI Number Information
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NPI Number | 1235658386
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Entity Type | Individual
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Provider Name | ILEANA UNGUREANU MD, PHD
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Gender | Female
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Dates
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Enumeration Date | 09/10/2017
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Last Update Date | 09/10/2017
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Provider Practice Location Address
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Address Line | 2424 40TH AVE APT 5
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City | MOLINE
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State | IL
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Zip | 61265-7215
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Country | US
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Telephone | 309-269-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 4925 N WOLCOTT AVE APT 2A
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City | CHICAGO
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State | IL
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Zip | 60640-3338
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Country | US
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Telephone | 315-751-7062
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 166001092
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License Number State | IL
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