Susan Wodzien-Gatziolis, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

209006489 Issued in IL

Practice address

2400 Belvidere Rd
Suite 100
Waukegan, IL 60085-6165

Phone

(847) 377-8440

Fax

(847) 377-8808

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1790805380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 TOWER CT STE 100",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313336",
            "telephone_number": "847-244-1375",
            "fax_number": "847-244-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 BELVIDERE RD",
            "address_2": "SUITE 100",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600856165",
            "telephone_number": "847-377-8440",
            "fax_number": "847-377-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WODZIEN-GATZIOLIS",
        "first_name": "SUSAN",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209006489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "041183777",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN LICENSE",
            "identifier": "209006489",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas M Winslow, DC
• Sara Winstanley, M.D.
• Tonya Winters
• Thomas Lamar Wise-Bey
• Wendy B Wise, COUNSELOR II
• Jonathan David Wong, DNP, APRN, FNP-C
• Seit Wong, MD
• Brenda Wood, RN
• Elizabeth Woods
• Kathleen Regina Woods, DMD

• Pediatric Nurse Practitioner in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Pediatric Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.