Provider Demographics
NPI:1104514090
Name:CZOCHARA, JADWIGA
Entity type:Individual
Prefix:
First Name:JADWIGA
Middle Name:
Last Name:CZOCHARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1942 DEMPSTER ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-1016
Mailing Address - Country:US
Mailing Address - Phone:224-610-2447
Mailing Address - Fax:
Practice Address - Street 1:1370 COVE DR
Practice Address - Street 2:
Practice Address - City:PROSPECT HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60070-1907
Practice Address - Country:US
Practice Address - Phone:773-443-5329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide