Individual
MITCHELL KORDZIKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3240 W DIVISION ST, CHICAGO, IL 60651-2405
(312) 413-7425
Mailing address
3240 W DIVISION ST, CHICAGO, IL 60651-2405
(312) 413-7425
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
041.430862
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.024040
IL
Other
Enumeration date
09/23/2021
Last updated
04/28/2023
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