Provider Demographics
NPI:1497142285
Name:KLUSACEK, NATALIA MONTOYA (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:NATALIA
Middle Name:MONTOYA
Last Name:KLUSACEK
Suffix:
Gender:
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211699
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-3699
Mailing Address - Country:US
Mailing Address - Phone:866-849-0692
Mailing Address - Fax:888-973-8821
Practice Address - Street 1:200 S WACKER DR FL 31
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-5877
Practice Address - Country:US
Practice Address - Phone:866-849-0692
Practice Address - Fax:888-973-8821
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041395324163W00000X
OR10006498363LF0000X
AL1-188919363LF0000X
TX1019558363LF0000X
HIAPRN-4809363LF0000X
AZ278994363LF0000X
COAPN.0997902-NP363LF0000X
AR218584363LF0000X
OK206313363LF0000X
IN71012282A363LF0000X
TN30504363LF0000X
MO2024047626363LF0000X
IL209013725363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse