Individual
KATARZYNA B IWANICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
250 W KENSINGTON RD STE 3B, MOUNT PROSPECT, IL 60056-1292
(622) 652-2887
(262) 764-0224
Mailing address
6127 GREEN BAY RD STE 100, KENOSHA, WI 53142-2941
(262) 652-2887
(262) 764-0224
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-002648
IL
Other
Enumeration date
01/11/2007
Last updated
09/03/2021
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