Individual ProviderPatrycja MazurNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1480 Jefferson St, Apt 202, Des Plaines, IL 60016-4485(312) 731-3999PECOS EnrollmentBased on the most recent information from CMS, provider Patrycja Mazur is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1922422328Provider TypeIndividualFull NameMazur, PatrycjaCredentialAPNGenderFemaleSole ProprietorNoEnumeration Date2/6/2014Last Updated1/1/2022Contact InformationPractice LocationPractice Address1480 Jefferson St, Apt 202, Des Plaines, IL 60016-4485Phone(312) 731-3999FaxUnlisted FaxMailing LocationMailing Address2160 S 1st Ave Bldg 6269, Loyola Univesity Medical Center, Maywood, IL 60153-3328Phone(312) 731-3999FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense209.011239IllinoisCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense041.377064Illinois