MEDICARE: EMILY SROCZYNSKI

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
1	363LF0000X	Family Nurse Practitioner	209.034495	IL

General Provider Information

NPI Number	:	1851226245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY SROCZYNSKI

Provider Business Mailing Address
First Line	:	77 OLD OAK TRL
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1245
Country	:	US
Telephone Number	:	708-743-0529
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 S MARYLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-1426
Country	:	US
Telephone Number	:	773-702-1220
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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