Provider Demographics
NPI:1740428572
Name:RELLES, MARIA REGINA (MD)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:REGINA
Last Name:RELLES
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 1:2851 S KING DR
Mailing Address - Street 2:APT. 611
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2950
Mailing Address - Country:US
Mailing Address - Phone:301-326-5044
Mailing Address - Fax:312-225-6877
Practice Address - Street 1:2851 S KING DR
Practice Address - Street 2:APT. 611
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2950
Practice Address - Country:US
Practice Address - Phone:301-326-5044
Practice Address - Fax:312-225-6877
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program