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NPI Code Detail

MEDICARE: MARGARET MARY KASPRZYK FNP-C

MEDICARE: MARGARET MARY KASPRZYK FNP-C
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 Practitioner209015370IL

General Provider Information

NPI Number : 1114448966
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET MARY KASPRZYK FNP-C
Provider Business Mailing Address
First Line : 817A W CORNELIA AVE APT 108
Second Line :
City : CHICAGO
State : IL
Zip : 60657-1792
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1645 W SCHOOL ST
Second Line :
City : CHICAGO
State : IL
Zip : 60657-2157
Country : US
Telephone Number : 773-227-3669
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2017
Last Update Date : 07/02/2017

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