Healthcare Provider Details

I. General information

NPI: 1285408351
Provider Name (Legal Business Name): KRISTA DAL POZZO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2023
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1964 SPRINGBROOK SQUARE DR STE 108B
NAPERVILLE IL
60564-5949
US

IV. Provider business mailing address

PO BOX 713260
CHICAGO IL
60677-1260
US

V. Phone/Fax

Practice location:
  • Phone: 630-348-3840
  • Fax:
Mailing address:
  • Phone: 630-469-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209028656
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: