Provider Demographics
NPI:1720528474
Name:MANKOWSKI, PATRICIA G (APN, FNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:G
Last Name:MANKOWSKI
Suffix:
Gender:F
Credentials:APN, FNP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:G
Other - Last Name:NEWBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FPA, APRN, FNP-BC
Mailing Address - Street 1:3249 OAK PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-3429
Mailing Address - Country:US
Mailing Address - Phone:708-783-7490
Mailing Address - Fax:
Practice Address - Street 1:3925 W 103RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655-3703
Practice Address - Country:US
Practice Address - Phone:772-298-3712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277.001648363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily