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Individual

MISS KATHLEEN A. ZACHARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN,RCS

Contact information

Practice address
6992 E ROCK GROVE RD, ROCK CITY, IL 61070-9522
(815) 865-5925
Mailing address
6992 E ROCK GROVE RD, ROCK CITY, IL 61070-9522
(815) 865-5925

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
043-026812
IL
164W00000X
Licensed Practical Nurse
Primary
307654-031
WI

Other

Enumeration date
02/12/2010
Last updated
02/12/2010
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