Provider Demographics
NPI:1295620508
Name:GUARDIANO, KATTRYN GAIL (APRN)
Entity type:Individual
Prefix:
First Name:KATTRYN
Middle Name:GAIL
Last Name:GUARDIANO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 27TH ST
Mailing Address - Street 2:
Mailing Address - City:ZION
Mailing Address - State:IL
Mailing Address - Zip Code:60099-2541
Mailing Address - Country:US
Mailing Address - Phone:847-984-5400
Mailing Address - Fax:
Practice Address - Street 1:224 W CLARENDON DR
Practice Address - Street 2:
Practice Address - City:ROUND LAKE BEACH
Practice Address - State:IL
Practice Address - Zip Code:60073-1896
Practice Address - Country:US
Practice Address - Phone:847-377-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.032492363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner