Basic Information
| Provider Information | |||||||||
| NPI: | 1003155375 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUENZI | ||||||||
| FirstName: | PATRICIA | ||||||||
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| Credential: | ANP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 132 SADDLE BROOK DR | ||||||||
| Address2: | |||||||||
| City: | OAK BROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605232663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308878746 | ||||||||
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| Practice Location | |||||||||
| Address1: | 329 REMINGTON BLVD STE 205 | ||||||||
| Address2: | |||||||||
| City: | BOLINGBROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604405817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6302261130 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2013 | ||||||||
| LastUpdateDate: | 05/04/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 209009593 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.