Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 209018692 | IL |
NPI | 1003371253 |
---|---|
Provider Name | Oksana Buryadnyk |
First Address | Skokie, IL 60077-1057 |
Second Address | Skokie, IL 60077-1057 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2019 |
Last Update Date | 20/04/2020 |