Individual
KRZYSZTOF WLOSEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 383-3087
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209015995
IL
363LF0000X
Family Nurse Practitioner
209.015995
IL
Other
Enumeration date
07/11/2017
Last updated
03/06/2020
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