Provider Demographics
NPI:1760818546
Name:TORRES, MARIA CRISTINA (MSTOM)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CRISTINA
Last Name:TORRES
Suffix:
Gender:F
Credentials:MSTOM
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:CRISTINA
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSTOM
Mailing Address - Street 1:175 N HARBOR DR APT 1501
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7856
Mailing Address - Country:US
Mailing Address - Phone:847-337-8057
Mailing Address - Fax:
Practice Address - Street 1:730 S DEARBORN ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-1838
Practice Address - Country:US
Practice Address - Phone:312-588-1104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198001154171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist