Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 209.011872 | IL |
NPI | 1083017263 |
---|---|
Provider Name | Nina Nicholas Jarosz |
First Address | Chicago, IL 60603-3200 |
Second Address | Chicago, IL 60603-3200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2014 |
Last Update Date | 16/03/2015 |