Healthcare Provider Details

I. General information

NPI: 1861678294
Provider Name (Legal Business Name): KATHRYN JULIA VANDERZWAN MS, APN/CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN JULIA SZIGETVARI MS, APN/CNP

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 RIDGE AVE
EVANSTON IL
60201-1718
US

IV. Provider business mailing address

2650 RIDGE AVE
EVANSTON IL
60201-1718
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-1463
  • Fax: 847-733-5108
Mailing address:
  • Phone: 847-570-1463
  • Fax: 847-733-5108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number209.006575
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: