Provider Demographics
NPI:1356031199
Name:CITU, ROXANA MIHAELA
Entity type:Individual
Prefix:
First Name:ROXANA
Middle Name:MIHAELA
Last Name:CITU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4711 GOLF RD STE 900
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1247
Mailing Address - Country:US
Mailing Address - Phone:312-671-2208
Mailing Address - Fax:224-251-7141
Practice Address - Street 1:10015 BEVERLY DR APT 303
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1058
Practice Address - Country:US
Practice Address - Phone:312-671-2208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILF03230513363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily