Provider Demographics
NPI:1164073599
Name:ZELENIK, JULIA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:ZELENIK
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9255 WATERFALL GLEN BLVD
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-5282
Mailing Address - Country:US
Mailing Address - Phone:630-880-2416
Mailing Address - Fax:
Practice Address - Street 1:9255 WATERFALL GLEN BLVD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-5282
Practice Address - Country:US
Practice Address - Phone:630-880-2416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209018468363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner