| Doctor Name: | MRS. JEANETTE MARIE RADZAK |
| NPI Number: | 1023070521 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 20900152 |
| Business Practice Address: | 5th Ave And Roosevelt Road Hines, IL - 60141 |
| Business Phone Number: | 7082022459 |
| Business Fax Number: | |
| Mailing Address: | 361 E Yorkfield Ave, ELMHURST |
| State: | IL |
| Postal Code: | 601265305 |
| Phone Number: | 6308330536 |
| Fax Number: | |
| NPI Enumeration Date: | 04/03/2006 |
| NPI Last Update Date: | 08/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 20900152 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |