Provider Demographics
NPI:1013404151
Name:KOLKA, LINDA MARIE (APN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:KOLKA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MARIE
Other - Last Name:KOLKA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LINDA MARIE KOLKA
Mailing Address - Street 1:333 SKOKIE BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1624
Mailing Address - Country:US
Mailing Address - Phone:630-508-9653
Mailing Address - Fax:
Practice Address - Street 1:333 SKOKIE BLVD STE 112
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1624
Practice Address - Country:US
Practice Address - Phone:224-205-7866
Practice Address - Fax:224-205-7865
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-14
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.017615363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty