Provider Demographics
NPI:1457921173
Name:STANISZEWSKI, JOANNA JANINA (MSN, APRN, AGNP-BC)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:JANINA
Last Name:STANISZEWSKI
Suffix:
Gender:F
Credentials:MSN, APRN, AGNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E WOODFIELD RD STE 113
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4786
Mailing Address - Country:US
Mailing Address - Phone:847-686-6866
Mailing Address - Fax:
Practice Address - Street 1:800 E WOODFIELD RD STE 113
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4786
Practice Address - Country:US
Practice Address - Phone:847-686-6866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-25
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041396546363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology