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NPI Code Detail

MEDICARE: MARCIA RADJA APN

MEDICARE: MARCIA RADJA APN
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 Practitioner209009942IL

General Provider Information

NPI Number : 1164776670
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCIA RADJA APN
Provider Business Mailing Address
First Line : 516 GRANT ST
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-3024
Country : US
Telephone Number : 630-413-1303
Fax Number : 888-311-3015
Provider Business Practice Location Address
First Line : 516 GRANT ST
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-3024
Country : US
Telephone Number : 630-413-1303
Fax Number : 888-311-3015
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2012
Last Update Date : 09/26/2025

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