Provider Demographics
NPI:1821721945
Name:CORAZZI, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CORAZZI
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 1:854 W ARMITAGE AVE APT 1R
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-5224
Mailing Address - Country:US
Mailing Address - Phone:708-595-9808
Mailing Address - Fax:
Practice Address - Street 1:854 W ARMITAGE AVE APT 1R
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-5224
Practice Address - Country:US
Practice Address - Phone:708-595-9808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070026628225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL070026628OtherPHYSICAL THERAPIST