Provider Demographics
NPI:1316341209
Name:PRZYBYLA, VANESSA (APN-CNP)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:PRZYBYLA
Suffix:
Gender:F
Credentials:APN-CNP
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7931 W COUNTRY CLUB LN
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-3533
Mailing Address - Country:US
Mailing Address - Phone:708-790-1952
Mailing Address - Fax:
Practice Address - Street 1:7931 W COUNTRY CLUB LN
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-3533
Practice Address - Country:US
Practice Address - Phone:708-790-1952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-21
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209011888363L00000X, 363LF0000X
IL277.001407207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily