Healthcare Provider Details

I. General information

NPI: 1104449412
Provider Name (Legal Business Name): URSZULA WINKIEWICZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2020
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E CHICAGO AVE
CHICAGO IL
60611-2991
US

IV. Provider business mailing address

5418 W WINDSOR AVE APT 2S
CHICAGO IL
60630-3533
US

V. Phone/Fax

Practice location:
  • Phone: 312-227-1400
  • Fax:
Mailing address:
  • Phone: 773-875-8493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number041.342835
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: