Individual
MARY L PRYKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8915 W GOLF RD, NILES, IL 60714-5905
(847) 827-9060
(847) 827-7196
Mailing address
25070 NETWORK PL, CHICAGO, IL 60673-1250
(847) 585-7000
(847) 240-0622
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209004174
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208179
MEDICARE PTAN
IL
Enumeration date
10/05/2005
Last updated
12/14/2021
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