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NPI Code Detail

MEDICARE: MARIALUISA DOUBEK FNP

MEDICARE: MARIALUISA DOUBEK FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner209014130IL

General Provider Information

NPI Number : 1841735222
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIALUISA DOUBEK FNP
Provider Business Mailing Address
First Line : 2001 S CALIFORNIA AVE STE 100
Second Line :
City : CHICAGO
State : IL
Zip : 60608-2486
Country : US
Telephone Number : 773-584-6200
Fax Number :
Provider Business Practice Location Address
First Line : 6550 S RICHMOND ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-2821
Country : US
Telephone Number : 773-309-4445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2016
Last Update Date : 09/29/2020

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Directions to “ MARIALUISA DOUBEK FNP” Practice Location

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