Provider Demographics
NPI:1922422328
Name:MAZUR, PATRYCJA (APN)
Entity Type:Individual
Prefix:
First Name:PATRYCJA
Middle Name:
Last Name:MAZUR
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:PATRYCJA
Other - Middle Name:
Other - Last Name:OKONSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:2160 S 1ST AVE BLDG 6269
Mailing Address - Street 2:LOYOLA UNIVESITY MEDICAL CENTER
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:312-731-3999
Mailing Address - Fax:
Practice Address - Street 1:1480 JEFFERSON ST
Practice Address - Street 2:APT 202
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4485
Practice Address - Country:US
Practice Address - Phone:312-731-3999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-06
Last Update Date:2022-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.377064163W00000X
IL209.011239363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse