Individual
MARIOLA KACZKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1875 DEMPSTER ST, SUITE 180, PARK RIDGE, IL 60068-1186
(847) 825-0800
Mailing address
PO BOX 2056, NORTHBROOK, IL 60065-2056
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209008582
IL
Other
Enumeration date
01/06/2011
Last updated
01/06/2011
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