Individual
AGNIESZKA NIECIUNSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3880 SALEM LAKE DR STE F, LONG GROVE, IL 60047-5292
(847) 719-2220
(847) 719-2265
Mailing address
2928 COVERT RD, GLENVIEW, IL 60025-4609
(708) 567-7502
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209017915
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018001749
ANCC CERTIFICATION
IL
05
—
209017915
—
IL
Enumeration date
08/22/2018
Last updated
07/11/2023
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