Provider Demographics
NPI:1881129377
Name:KAZANA, IZABELA (DNP, APN)
Entity type:Individual
Prefix:DR
First Name:IZABELA
Middle Name:
Last Name:KAZANA
Suffix:
Gender:F
Credentials:DNP, APN
Other - Prefix:MS
Other - First Name:IZABELA
Other - Middle Name:
Other - Last Name:PIECH, WANKOWSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3770 N OCONTO AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-3524
Mailing Address - Country:US
Mailing Address - Phone:708-420-6806
Mailing Address - Fax:
Practice Address - Street 1:5841 S MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1447
Practice Address - Country:US
Practice Address - Phone:773-702-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-22
Last Update Date:2017-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041322017363LP2300X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care