Provider Demographics
NPI:1972907459
Name:KAGAN, VIKTORIYA (APRN, CNP)
Entity type:Individual
Prefix:
First Name:VIKTORIYA
Middle Name:
Last Name:KAGAN
Suffix:
Gender:
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 N SAINT CLAIR ST STE 600
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2981
Mailing Address - Country:US
Mailing Address - Phone:312-664-3278
Mailing Address - Fax:312-695-0063
Practice Address - Street 1:676 N SAINT CLAIR ST STE 600
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2981
Practice Address - Country:US
Practice Address - Phone:312-664-3278
Practice Address - Fax:312-695-0063
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-13
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209011995363LA2100X
IL277002454363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care