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General NPI Number Information
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NPI Number | 1083402119
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Entity Type | Individual
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Provider Name | VICTORIA MARIE RENDULIC APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/29/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 14290 S LA GRANGE RD
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City | ORLAND PARK
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State | IL
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Zip | 60462-2023
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Country | US
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Telephone | 888-824-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 1337 S INDIANA PKWY
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City | CHICAGO
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State | IL
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Zip | 60605-2619
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Country | US
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Telephone | 412-841-3010
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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 | 209031694
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 209031694
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License Number State | IL
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