Healthcare Provider Details

I. General information

NPI: 1750209599
Provider Name (Legal Business Name): NICOLE ZNOSKO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 W HARRISON ST
CHICAGO IL
60612-3801
US

IV. Provider business mailing address

5343 N DELPHIA AVE APT 243
CHICAGO IL
60656-2553
US

V. Phone/Fax

Practice location:
  • Phone: 312-947-3155
  • Fax:
Mailing address:
  • Phone: 773-640-3173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: