Provider Demographics
NPI:1598434540
Name:ZUBOVICH, VICTORIA GENNADIEVNA
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:GENNADIEVNA
Last Name:ZUBOVICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 BUCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-1415
Mailing Address - Country:US
Mailing Address - Phone:224-392-2086
Mailing Address - Fax:
Practice Address - Street 1:1425 N HUNT CLUB RD STE 301
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-2639
Practice Address - Country:US
Practice Address - Phone:262-234-2232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-12
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.023987363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care