Provider Demographics
NPI:1295229292
Name:TORRES PEREZ-IGLESIAS, CAROLINA ALEJANDRA (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:ALEJANDRA
Last Name:TORRES PEREZ-IGLESIAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 W SURF ST APT 307
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-6123
Mailing Address - Country:US
Mailing Address - Phone:773-620-3663
Mailing Address - Fax:
Practice Address - Street 1:836 W WELLINGTON AVE STE 4800
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5147
Practice Address - Country:US
Practice Address - Phone:773-296-7093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125072399208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery