Provider Demographics
NPI:1184997843
Name:KOLAR, MARION S (MSN, RN, FNP-BC)
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:S
Last Name:KOLAR
Suffix:
Gender:F
Credentials:MSN, RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2736
Mailing Address - Country:US
Mailing Address - Phone:630-617-2830
Mailing Address - Fax:
Practice Address - Street 1:110 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2736
Practice Address - Country:US
Practice Address - Phone:630-617-2830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-10
Last Update Date:2021-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.398188163W00000X
IN28170723A163W00000X
IL209009878363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse