| Doctor Name: | JUDITH D MAGDZIARZ |
| NPI Number: | 1104925692 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 041-118752 |
| Business Practice Address: | 1701 E Court St Kankakee, IL - 609012670 |
| Business Phone Number: | 8159359395 |
| Business Fax Number: | 8159351187 |
| Mailing Address: | Po Box 781, KANKAKEE |
| State: | IL |
| Postal Code: | 609010781 |
| Phone Number: | 8159357256 |
| Fax Number: | 8159357340 |
| NPI Enumeration Date: | 09/21/2006 |
| NPI Last Update Date: | 07/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 041-118752 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |