Provider Demographics
NPI:1508841701
Name:SOLEANICOV, ANA-MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANA-MARIA
Middle Name:
Last Name:SOLEANICOV
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 1:1601 PARKVIEW AVE
Mailing Address - Street 2:CREDENTIALING S200
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-1822
Mailing Address - Country:US
Mailing Address - Phone:815-395-5851
Mailing Address - Fax:815-395-5644
Practice Address - Street 1:2780 MCFARLAND RD
Practice Address - Street 2:UNIVERSITY WOMEN & CHILDREN'S HEALTH CENTER
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-6807
Practice Address - Country:US
Practice Address - Phone:815-637-0000
Practice Address - Fax:815-637-0040
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG31555OtherUPIN
IL392690Medicare ID - Type UnspecifiedMEDICARE PROV ID#