Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 036-110897 | IL |
NPI | 1033222104 |
---|---|
Provider Name | Mrs. Beata Agnieszka Kisiel |
First Address | Joliet, IL 60435-6544 |
Second Address | Joliet, IL 60435-6544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 04/03/2014 |