Provider Demographics
NPI:1346560323
Name:MORICI, ANN MARIE (RN)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:
Last Name:MORICI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6900 MAIN ST
Mailing Address - Street 2:SUITE 60
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-3454
Mailing Address - Country:US
Mailing Address - Phone:630-964-5330
Mailing Address - Fax:630-445-4033
Practice Address - Street 1:6900 MAIN ST
Practice Address - Street 2:SUITE 60
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-3454
Practice Address - Country:US
Practice Address - Phone:630-964-5330
Practice Address - Fax:630-445-4033
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL041-211658163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL26-0970590OtherSTATE OF ILLINOIS