Provider Demographics
NPI:1164044079
Name:MARCINKOWSKI, NATALIA (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:MARCINKOWSKI
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 PATRIOT BLVD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8039
Mailing Address - Country:US
Mailing Address - Phone:847-535-7647
Mailing Address - Fax:847-998-9733
Practice Address - Street 1:2701 PATRIOT BLVD
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8039
Practice Address - Country:US
Practice Address - Phone:847-535-7647
Practice Address - Fax:847-998-9733
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL423809163W00000X
IL020266363LF0000X
IL209020266363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily