Provider Demographics
NPI:1710420245
Name:CHELARIU, BRISTENA OLIVIA
Entity Type:Individual
Prefix:
First Name:BRISTENA
Middle Name:OLIVIA
Last Name:CHELARIU
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 1:122 MURRAY DR
Mailing Address - Street 2:
Mailing Address - City:WOOD DALE
Mailing Address - State:IL
Mailing Address - Zip Code:60191-2239
Mailing Address - Country:US
Mailing Address - Phone:773-988-9983
Mailing Address - Fax:
Practice Address - Street 1:122 MURRAY DR
Practice Address - Street 2:
Practice Address - City:WOOD DALE
Practice Address - State:IL
Practice Address - Zip Code:60191-2239
Practice Address - Country:US
Practice Address - Phone:773-988-9983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist