Provider Demographics
NPI:1689716953
Name:IONESCU, OFELIA MARTHA (MD)
Entity Type:Individual
Prefix:
First Name:OFELIA
Middle Name:MARTHA
Last Name:IONESCU
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 1:2620 W GREENLEAF ST #2W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645
Mailing Address - Country:US
Mailing Address - Phone:773-551-2493
Mailing Address - Fax:773-293-7947
Practice Address - Street 1:150 E HURON ST #1306
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:773-551-2493
Practice Address - Fax:773-293-7942
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361028192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036102819Medicaid
IL1632551OtherBCBS
IL1632551OtherBCBS
H32010Medicare UPIN