Provider Demographics
NPI:1649665415
Name:TOSKI, NATALIE RONCALLO (MD)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:RONCALLO
Last Name:TOSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:RONCALLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4525 N RAVENSWOOD AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5201
Mailing Address - Country:US
Mailing Address - Phone:312-857-8794
Mailing Address - Fax:
Practice Address - Street 1:1500 S MAIN ST
Practice Address - Street 2:UNIT 3301
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4917
Practice Address - Country:US
Practice Address - Phone:817-702-3431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00629942084P0800X
PAMD4688382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry