MEDICARE: DR. MARGARITA ADELINA MORALES DMD

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
1	122300000X	Dentist	019.033648	IL

General Provider Information

NPI Number	:	1982343422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARGARITA ADELINA MORALES DMD

Provider Business Mailing Address
First Line	:	51 E 14TH ST APT 1102
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-2998
Country	:	US
Telephone Number	:	915-246-8945
Fax Number	:

Provider Business Practice Location Address
First Line	:	3004 W 26TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-4128
Country	:	US
Telephone Number	:	773-231-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2022
Last Update Date	:	06/02/2022

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