Provider Demographics
NPI:1285038778
Name:ZYBAK, KAREN ANNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ANNE
Last Name:ZYBAK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:ANNE
Other - Last Name:KRYDYNSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20211 S JONQUIL LN
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-8350
Mailing Address - Country:US
Mailing Address - Phone:815-464-0116
Mailing Address - Fax:
Practice Address - Street 1:20211 S JONQUIL LN
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-8350
Practice Address - Country:US
Practice Address - Phone:815-464-0116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.341773163W00000X
IL043.088604164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse