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NPI 1902508328

NPI 1902508328 : MARIANA HDEZ GLEZ MONJE MD, PHD : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1902508328
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    Entity Type          |    Individual 
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    Provider Name        |    MARIANA HDEZ GLEZ MONJE MD, PHD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/20/2023
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    Last Update Date     |    09/02/2025
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Provider Practice Location Address
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    Address Line         |    259 E ERIE ST STE 1900 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60611-3246
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    Country              |    US
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    Telephone            |    312-695-7950
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    Fax                  |    312-695-5747
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Provider Business Mailing Address
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    Address Line         |    251 E HURON ST 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60611-3055
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    Country              |    US
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    Telephone            |    312-926-2000
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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        |    2084N0400X
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    Taxonomy Name        |    Neurology Physician
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    License Number       |    125.082901
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    License Number State |    IL
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    2084N0400X
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    Taxonomy Name        |    Neurology Physician
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    License Number       |    036176857
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    License Number State |    IL
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