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Individual

MS. JUSTYNA E POMIOTLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
1401 N WESTERN AVE, CHICAGO, IL 60622-1735
(708) 292-7000
(708) 887-5874
Mailing address
PO BOX 746715, ATLANTA, GA 30374-6715
(708) 292-7000
(708) 887-5874

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
28168329A
IN
363LF0000X
Family Nurse Practitioner
Primary
209.012475
IL
363LF0000X
Family Nurse Practitioner
Primary
277.005097
IL
363LF0000X
Family Nurse Practitioner
71005312A
IN

Other

Enumeration date
11/20/2014
Last updated
04/01/2026
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