Healthcare Provider Details
I. General information
NPI: 1205665825
Provider Name (Legal Business Name): VICTORIA GAYE ZURKOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/31/2024
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17W535 BUTTERFIELD RD STE 1
OAKBROOK TERRACE IL
60181-4010
US
IV. Provider business mailing address
257 N OAKLAWN AVE
ELMHURST IL
60126-2522
US
V. Phone/Fax
- Phone: 630-207-2603
- Fax:
- Phone: 630-207-2603
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | F05240652 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: