Provider Demographics
NPI:1639303761
Name:KARCZYNSKI, KRISTEN C (ANP-BC)
Entity Type:Individual
Prefix:MISS
First Name:KRISTEN
Middle Name:C
Last Name:KARCZYNSKI
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 N LAKE SHORE DR STE 1000
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-8709
Mailing Address - Country:US
Mailing Address - Phone:312-695-9797
Mailing Address - Fax:
Practice Address - Street 1:676 N SAINT CLAIR ST STE 2210
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2922
Practice Address - Country:US
Practice Address - Phone:312-695-8143
Practice Address - Fax:312-695-3141
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.007543363LA2200X
NYF307149363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health