Provider Demographics
NPI:1427894716
Name:FAVERO DE MORAES, JULIANA (ND)
Entity type:Individual
Prefix:DR
First Name:JULIANA
Middle Name:
Last Name:FAVERO DE MORAES
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E ROOSEVELT RD # PMD70
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4539
Mailing Address - Country:US
Mailing Address - Phone:561-909-5239
Mailing Address - Fax:
Practice Address - Street 1:200 E ROOSEVELT RD # PMD70
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4539
Practice Address - Country:US
Practice Address - Phone:561-909-5239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath