Individual
EWA RAFACZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
9831 S WESTERN AVE, CHICAGO, IL 60643-1740
(773) 445-3500
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.295516
IL
363L00000X
Nurse Practitioner
Primary
277.000664
IL
363LA2200X
Adult Health Nurse Practitioner
209.014365
IL
Other
Enumeration date
09/02/2016
Last updated
05/10/2022
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