Provider Demographics
NPI:1619018520
Name:MARABELLA ALHAMBRA MD S.C.
Entity Type:Organization
Organization Name:MARABELLA ALHAMBRA MD S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MANOLO
Authorized Official - Middle Name:
Authorized Official - Last Name:ABALOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-397-4600
Mailing Address - Street 1:4775 MANHATTAN DR
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-2264
Mailing Address - Country:US
Mailing Address - Phone:815-397-4600
Mailing Address - Fax:
Practice Address - Street 1:4775 MANHATTAN DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-2264
Practice Address - Country:US
Practice Address - Phone:815-397-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty