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General NPI Number Information
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NPI Number | 1003461336
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Entity Type | Individual
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Provider Name | VANJA Z RISSKY FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 12/03/2021
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Provider Practice Location Address
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Address Line | CANCER TREATMENT CENTERS OF AMERICA 2520 ELISHA AVENUE
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City | ZION
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State | IL
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Zip | 60099
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Country | US
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Telephone | 800-322-9183
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Fax |
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Provider Business Mailing Address
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Address Line | CANCER TREATMENT CENTERS OF AMERICA 2361 PAYSPHERE CIRCLE
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City | CHICAGO
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State | IL
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Zip | 60674
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Country | US
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Telephone | 800-322-9183
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9220-33
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9220
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209.024000
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License Number State | IL
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