Provider Demographics
NPI:1902853773
Name:BELTRAN, NORA (MD)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:BELTRAN
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 1:3731 CINDY LN
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-3781
Mailing Address - Country:US
Mailing Address - Phone:224-703-2033
Mailing Address - Fax:
Practice Address - Street 1:2400 BELVIDERE RD
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-6165
Practice Address - Country:US
Practice Address - Phone:847-377-8440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-068-408207QG0300X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine