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NPI Code Detail

MEDICARE: MARJORIE KOZLOWSKI DNP, APRN, FNP-BC

MEDICARE: MARJORIE KOZLOWSKI DNP, APRN, FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner209004948IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1209004948OTHERILAPN

General Provider Information

NPI Number : 1760466379
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARJORIE KOZLOWSKI DNP, APRN, FNP-BC
Provider Business Mailing Address
First Line : 941 N WILLIAMS DR
Second Line :
City : PALATINE
State : IL
Zip : 60074-7254
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5359 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1450
Country : US
Telephone Number : 773-836-2785
Fax Number : 773-836-7381
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2005
Last Update Date : 03/07/2023

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