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TOMASZ BOLTRUCZYK FNP-C
NPI 1093564411
Nurse Practitioner - Family in Great Lakes, IL

Active since May 17, 2024
3420 ILLINOIS ST, GREAT LAKES, IL 60088(847) 688-5568 Get Directions Write a Review

NPPES record last updated: March 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 2, 2025, May 17, 2024 (2 updates tracked since 2024).

About Tomasz Boltruczyk Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TOMASZ BOLTRUCZYK FNP-C (NPI 1093564411) is an individual family provider in Great Lakes, Illinois, licensed in Illinois (209029481) and active in the NPI registry since May 2024.

NPPES Registry Identity

NPI1093564411
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameTOMASZ BOLTRUCZYKCredential: FNP-C
Location Address3420 ILLINOIS STGreat Lakes, IL 60088-3161
Mailing Address5991 Ruby StRosemont, IL 60018-4431 · (254) 338-7481
Phone(847) 688-5568
Sole ProprietorYes
Enumeration DateMay 17, 2024
Last NPPES UpdateMarch 2, 20252 updates tracked since enumeration
NPPES CertifiedMarch 2, 2025
✔ NPI 1093564411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209029481
3420 ILLINOIS ST, Great Lakes, IL 60088
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Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY J BAKER DPT
Physical Therapist
3420 ILLINOIS ST
GREAT LAKES, IL 60088
Lake County (847) 688-6755
MR. WARREN K KENNEDY PA-C
Physician Assistant (Medical)
3420 ILLINOIS ST
GREAT LAKES, IL 60088
Lake County (847) 688-2522
MR. WILLIAM HARRELD PETERSON PA-C
Physician Assistant
3420 ILLINOIS ST, USS TRANQUILITY MEDICAL CLINIC 1007
GREAT LAKES, IL 60088
Lake County (847) 688-6755
DR. JASON YUNGSUP KIM MD
Family Medicine
3420 ILLINOIS ST, USS TRANQUILLITY CLINIC 1007
GREAT LAKES, IL 60088
Lake County (847) 688-6755
JAMES A LOVELL FHCC
Military/U.S. Coast Guard Pharmacy
3420 ILLINOIS ST, USS TRANQUILITYAH14 MED CLN 1017
GREAT LAKES, IL 60088
Lake County (847) 688-2100
DR. NEMESIA FIGUERAS ARTATES M.D.
General Practice
3420 ILLINOIS ST
GREAT LAKES, IL 60088
Lake County (847) 688-6755
DR. JOHN E. DALTON PH.D.
Psychologist (Clinical)
3420 ILLINOIS ST, REU, BUILDING 1007
GREAT LAKES, IL 60088
Lake County (847) 688-7406
JAMES A LOVELL FHCC
Military/U.S. Coast Guard Pharmacy
3420 ILLINOIS ST, AH14 MEDICAL CLINIC
GREAT LAKES, IL 60088
Lake County (847) 688-7406

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tomasz Boltruczyk's NPI number?

The NPI number for Tomasz Boltruczyk is 1093564411. It was assigned to this individual provider in the NPPES registry on May 17, 2024.

Where is Tomasz Boltruczyk located?

Tomasz Boltruczyk practices at 3420 Illinois St, Great Lakes, IL 60088. The listed phone number is (847) 688-5568.

What is Tomasz Boltruczyk's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Tomasz Boltruczyk was last updated on March 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.