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NPI Code Detail

MEDICARE: NIKOLA ROSZKO AUGUSTYNOWICZ APRN

MEDICARE:   NIKOLA  ROSZKO AUGUSTYNOWICZ  APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner209.027572IL

General Provider Information

NPI Number : 1104604255
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIKOLA ROSZKO AUGUSTYNOWICZ APRN
Provider Business Mailing Address
First Line : 2650 RIDGE AVE STE 1223
Second Line :
City : EVANSTON
State : IL
Zip : 60201-1700
Country : US
Telephone Number : 847-570-2040
Fax Number : 847-733-5315
Provider Business Practice Location Address
First Line : 155 E BRUSH HILL RD
Second Line :
City : ELMHURST
State : IL
Zip : 60126-5658
Country : US
Telephone Number : 331-221-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2023
Last Update Date : 01/26/2026

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Directions to “ NIKOLA ROSZKO AUGUSTYNOWICZ APRN” Practice Location

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