Healthcare Provider Details

I. General information

NPI: 1851787733
Provider Name (Legal Business Name): ANNA KOZIOL APN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2015
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 S ROSELLE RD
SCHAUMBURG IL
60193-2925
US

IV. Provider business mailing address

519 S ROSELLE RD
SCHAUMBURG IL
60193-2925
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-0535
  • Fax: 630-671-4989
Mailing address:
  • Phone: 847-618-0535
  • Fax: 630-671-4989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209012664
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: