Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 209018217 | IL |
NPI | 1093290421 |
---|---|
Provider Name | Patrycja Nowak |
First Address | Elk Grove Village, IL 60007-3367 |
Second Address | Elk Grove Village, IL 60007-3367 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2018 |
Last Update Date | 06/04/2021 |