Individual
KATHLEEN ANN KOCIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MS, GNP-BC
Contact information
Practice address
2850 W 95TH ST, SUITE 106, EVERGREEN PARK, IL 60805-2735
(708) 425-9399
Mailing address
2800 W 87TH ST, CHICAGO, IL 60652-3831
(773) 863-7503
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
209-004338
IL
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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