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General NPI Number Information
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NPI Number | 1851026306
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Entity Type | Individual
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Provider Name | NATALIYA MOSTOVYY FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 10/07/2022
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Provider Practice Location Address
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Address Line | 9017 FULLERTON AVE APT SUITE
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City | RIVER GROVE
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State | IL
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Zip | 60171-1811
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Country | US
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Telephone | 773-516-1743
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Fax |
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Provider Business Mailing Address
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Address Line | 9017 FULLERTON AVE APT SUITE
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City | RIVER GROVE
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State | IL
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Zip | 60171-1811
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Country | US
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Telephone | 773-516-1743
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2022002002
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License Number State | IL
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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 | 209.025384
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License Number State | IL
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