Provider Demographics
NPI:1972094449
Name:ANDRIUSIS, RITA J (RN)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:J
Last Name:ANDRIUSIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17237 FONTANA LN
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-4874
Mailing Address - Country:US
Mailing Address - Phone:708-431-5998
Mailing Address - Fax:
Practice Address - Street 1:17253 FONTANA LN
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-4863
Practice Address - Country:US
Practice Address - Phone:815-838-5258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.173240163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health