Organization
NONE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZACHARY KOSYLA RN,BSN,CNOR,RNFA (RNFA)
(773) 802-3940
Entity
Organization
Contact information
Practice address
2323 W 114TH ST, CHICAGO, IL 60643-4108
(773) 802-3940
Mailing address
2323 W 114TH ST, CHICAGO, IL 60643-4108
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
041296369
IL
Other
Enumeration date
04/30/2014
Last updated
04/30/2014
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