Individual
SUSAN WODZIEN-GATZIOLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
2400 BELVIDERE RD, SUITE 100, WAUKEGAN, IL 60085-6165
(847) 377-8440
(847) 377-8808
Mailing address
15 TOWER CT STE 100, GURNEE, IL 60031-3336
(847) 244-1375
(847) 244-1002
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209006489
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041183777
RN LICENSE
IL
01
—
209006489
APN LICENSE
IL
Enumeration date
03/29/2007
Last updated
08/19/2008
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