Healthcare Provider Details

I. General information

NPI: 1780502518
Provider Name (Legal Business Name): MARY ZAWLOCKI DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

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

5841 S MARYLAND AVE
CHICAGO IL
60637-1443
US

IV. Provider business mailing address

914 COUNTRY LN
BUFFALO GROVE IL
60089-1939
US

V. Phone/Fax

Practice location:
  • Phone: 224-305-5414
  • Fax:
Mailing address:
  • Phone: 224-305-5414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209.034357
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: