Judith D Magdziarz, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

041-118752 Issued in IL

Practice address

1701 E Court St
Kankakee, IL 60901-2670

Phone

(815) 935-9395

Fax

(815) 935-1187

NPI assigned

Sep 21, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248912000000",
    "number": "1104925692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609010781",
            "telephone_number": "815-935-7256",
            "fax_number": "815-935-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E COURT ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012670",
            "telephone_number": "815-935-9395",
            "fax_number": "815-935-1187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGDZIARZ",
        "first_name": "JUDITH",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2009-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "041-118752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Kankakee, IL
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.