Doctor Name: | DOROTA CZERNECKI |
NPI Number: | 1245691799 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 209014026 |
Business Practice Address: | 8807 W 97th Pl Palos Hills, IL - 604651015 |
Business Phone Number: | 7087249743 |
Business Fax Number: | |
Mailing Address: | 8807 W 97th Pl, PALOS HILLS |
State: | IL |
Postal Code: | 604651015 |
Phone Number: | 7087249743 |
Fax Number: | |
NPI Enumeration Date: | 03/11/2016 |
NPI Last Update Date: | 03/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | 209014026 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |