Individual
MARIOLA U GRZESZCZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5875 E RIVERSIDE BLVD, ROCKFORD, IL 61114-4937
(815) 398-9491
(815) 381-7498
Mailing address
40 75TH ST, WILLOWBROOK, IL 60527-2325
(630) 581-5372
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209022930
IL
363LF0000X
Family Nurse Practitioner
2019055819
IL
363LF0000X
Family Nurse Practitioner
209022930
IL
Other
Enumeration date
07/30/2020
Last updated
02/28/2025
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