Provider Demographics
NPI:1558088427
Name:SZCZEPANIK, MONIQUE L (FNP)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:L
Last Name:SZCZEPANIK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 PHEASANT CHASE DR
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-4511
Mailing Address - Country:US
Mailing Address - Phone:630-408-0800
Mailing Address - Fax:
Practice Address - Street 1:730 S WEBER RD
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60490-5472
Practice Address - Country:US
Practice Address - Phone:630-378-2000
Practice Address - Fax:844-971-6928
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-21
Last Update Date:2024-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209026193363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily