Individual
KIMBERLY PIECZYNSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2900 FOXFIELD RD, SUITE 203, ST CHARLES, IL 60174-5799
(630) 797-4255
(630) 797-4259
Mailing address
2900 FOXFIELD RD, SUITE 203, ST CHARLES, IL 60174-5799
(630) 797-4255
(630) 797-4259
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209 003073
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0222075
CDPG BCBS
IL
01
—
1033149844
CDPG NPI
IL
01
—
920540
MEDICARE PTAN (GROUP)
—
01
—
920540008
MEDICARE PTAN (INDIVIDUAL)
—
Enumeration date
01/17/2007
Last updated
03/18/2011
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