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General NPI Number Information
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NPI Number | 1598434540
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Entity Type | Individual
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Provider Name | VICTORIA GENNADIEVNA ZUBOVICH
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Gender | Female
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Dates
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Enumeration Date | 09/12/2021
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 1425 N HUNT CLUB RD STE 301
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City | GURNEE
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State | IL
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Zip | 60031-2639
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Country | US
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Telephone | 262-234-2232
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Fax |
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Provider Business Mailing Address
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Address Line | 1728 BUCKINGHAM RD
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City | MUNDELEIN
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State | IL
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Zip | 60060-1415
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Country | US
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Telephone | 224-392-2086
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 209.023987
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License Number State | IL
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