Healthcare Provider Details

I. General information

NPI: 1568094803
Provider Name (Legal Business Name): KLAUDIA MAGDALENA GWOZDZ ARPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 S CALIFORNIA AVE
CHICAGO IL
60608-1732
US

IV. Provider business mailing address

521 W CENTRAL RD
MOUNT PROSPECT IL
60056-6514
US

V. Phone/Fax

Practice location:
  • Phone: 773-542-2000
  • Fax:
Mailing address:
  • Phone: 224-877-6186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.020387
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: