Individual
SUSAN A KOVARIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
221 3RD ST, LIBERTYVILLE, IL 60048-2303
(847) 280-7403
Mailing address
221 3RD ST, LIBERTYVILLE, IL 60048-2303
(847) 280-7403
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041215097
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209024309
IL
Other
Enumeration date
02/06/2023
Last updated
03/07/2024
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