Provider Demographics
NPI:1073274452
Name:MORALES, ARGENTINA (PA-C)
Entity Type:Individual
Prefix:
First Name:ARGENTINA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 E ERIE ST STE 2040
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2994
Mailing Address - Country:US
Mailing Address - Phone:312-695-8346
Mailing Address - Fax:312-695-4620
Practice Address - Street 1:259 E ERIE ST STE 2040
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2994
Practice Address - Country:US
Practice Address - Phone:312-695-8346
Practice Address - Fax:312-695-4620
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085009778363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant