Provider Demographics
NPI:1063860831
Name:RAFAEL, MARGARIDA
Entity Type:Individual
Prefix:
First Name:MARGARIDA
Middle Name:
Last Name:RAFAEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N MCCLURG CT
Mailing Address - Street 2:APT 3312
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4323
Mailing Address - Country:US
Mailing Address - Phone:773-699-3835
Mailing Address - Fax:
Practice Address - Street 1:400 N MCCLURG CT
Practice Address - Street 2:APT 3312
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4323
Practice Address - Country:US
Practice Address - Phone:773-699-3835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program