Provider Demographics
NPI:1477924710
Name:DELGADO, LORENA ULLOA
Entity Type:Individual
Prefix:MRS
First Name:LORENA
Middle Name:ULLOA
Last Name:DELGADO
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 1:12 S MIDLAND AVE
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60436-1302
Mailing Address - Country:US
Mailing Address - Phone:815-725-3037
Mailing Address - Fax:815-409-7833
Practice Address - Street 1:12 S MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60436-1302
Practice Address - Country:US
Practice Address - Phone:815-725-3037
Practice Address - Fax:815-409-7833
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter