Provider Demographics
NPI:1437974656
Name:DIAZ MORALES, GABRIELA MELISSA (NP)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:MELISSA
Last Name:DIAZ MORALES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 N WIELAND ST APT 202
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-1264
Mailing Address - Country:US
Mailing Address - Phone:847-494-3301
Mailing Address - Fax:
Practice Address - Street 1:2525 S MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2315
Practice Address - Country:US
Practice Address - Phone:312-567-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.031105363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner