Provider Demographics
NPI:1376362749
Name:CEGLINSKI, KATARZYNA (CPNP)
Entity type:Individual
Prefix:
First Name:KATARZYNA
Middle Name:
Last Name:CEGLINSKI
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 N HIGHVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2226
Mailing Address - Country:US
Mailing Address - Phone:773-551-3294
Mailing Address - Fax:
Practice Address - Street 1:7450 W 63RD ST
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:IL
Practice Address - Zip Code:60501-1816
Practice Address - Country:US
Practice Address - Phone:708-458-0757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.030160363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics