Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 209009593 | IL |
NPI | 1003155375 |
---|---|
Provider Name | Patricia Kuenzi |
First Address | Oak Brook, IL 60523-2663 |
Second Address | Bolingbrook, IL 60440-5817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2013 |
Last Update Date | 04/05/2016 |