Provider Demographics
NPI:1851026306
Name:MOSTOVYY, NATALIYA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:NATALIYA
Middle Name:
Last Name:MOSTOVYY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9017 FULLERTON AVE APT SUITE
Mailing Address - Street 2:
Mailing Address - City:RIVER GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60171-1811
Mailing Address - Country:US
Mailing Address - Phone:773-516-1743
Mailing Address - Fax:
Practice Address - Street 1:9017 FULLERTON AVE APT SUITE
Practice Address - Street 2:
Practice Address - City:RIVER GROVE
Practice Address - State:IL
Practice Address - Zip Code:60171-1811
Practice Address - Country:US
Practice Address - Phone:773-516-1743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2022002002363LF0000X
IL209.025384363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily