Individual provider Active NPI

Nora Mariduena, PSYD

  • Student in an Organized Health Care Education/Training Program
  • Oak Park, IL
National Provider Identifier
1619136769
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1515 N Harlem Ave
Suite 304
Oak Park, IL 60302-1205
Phone
(708) 383-3405
Fax
(708) 383-3406
NPI assigned
Jun 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1515 N Harlem Ave
Suite 304
Oak Park, IL 60302-1205

Mailing address

1515 N Harlem Ave
Suite 304
Oak Park, IL 60302-1205
Phone (708) 383-3405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212537600000",
    "number": "1619136769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N HARLEM AVE",
            "address_2": "SUITE 304",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021205",
            "telephone_number": "708-383-3405",
            "fax_number": "708-383-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N HARLEM AVE",
            "address_2": "SUITE 304",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021205",
            "telephone_number": "708-383-3405",
            "fax_number": "708-383-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIDUENA",
        "first_name": "NORA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-04",
        "last_updated": "2008-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.