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General NPI Number Information
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NPI Number | 1649874660
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Entity Type | Individual
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Provider Name | MARIYA DUQUENE
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Gender | Female
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 932 N WRIGHT ST
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City | NAPERVILLE
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State | IL
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Zip | 60563-3600
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Country | US
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Telephone | 630-428-9001
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Fax |
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Provider Business Mailing Address
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Address Line | 1424 QUINCY BRIDGE CT
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City | BARTLETT
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State | IL
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Zip | 60103-1811
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Country | US
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Telephone | 773-320-9000
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 227016753
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 198001531
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License Number State | IL
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