Individual
SAMANTHA R KAUCHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5875 E RIVERSIDE BLVD, ROCKFORD, IL 61114-4937
(815) 398-9491
(815) 381-7498
Mailing address
PO BOX 735263, CHICAGO, IL 60673-5263
(815) 398-9491
(815) 381-7498
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041428462
IL
363L00000X
Nurse Practitioner
Primary
209026147
IL
Other
Enumeration date
10/03/2022
Last updated
12/17/2024
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