MEDICARE: PATRICIA JEAN ZOLLER

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	209.019946	IL

General Provider Information

NPI Number	:	1932740123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA JEAN ZOLLER

Provider Business Mailing Address
First Line	:	9312 S HOYNE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-6305
Country	:	US
Telephone Number	:	773-230-4521
Fax Number	:

Provider Business Practice Location Address
First Line	:	9312 S HOYNE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-6305
Country	:	US
Telephone Number	:	773-230-4521
Fax Number	:

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

Provider Enumeration Date	:	09/30/2019
Last Update Date	:	04/15/2026

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Directions to “ PATRICIA JEAN ZOLLER ” Practice Location

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