Mary Kotjabaldiri, APN-PMHNP - Nurse Practitioner in River Forest, IL

Mary Kotjabaldiri, APN-PMHNP is a Nurse Practitioner - Psychiatric/mental Health based in River Forest, Illinois. Mary Kotjabaldiri is licensed to practice in Illinois (license number 209035881) and her current practice location is 7765 Lake St Apt 2w, River Forest, Illinois. She can be reached at her office (for appointments etc.) via phone at (708) 955-6144.

NPI number for Mary Kotjabaldiri is 1467388710 and her current mailing address is 7765 Lake St Apt 2w, River Forest, Illinois. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1467388710.

Contact Information

Mary Kotjabaldiri, APN-PMHNP
7765 Lake St Apt 2w,
River Forest, IL 60305-1732
(708) 955-6144
Not Available

Map and Direction




Provider's Profile

Full NameMary Kotjabaldiri
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location7765 Lake St Apt 2w, River Forest, Illinois
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1467388710
  • Provider Enumeration Date: 06/23/2026
  • Last Update Date: 06/23/2026

Medical Identifiers

Medical identifiers for Mary Kotjabaldiri such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1467388710NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health 209035881 (Illinois)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mary Kotjabaldiri is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mary Kotjabaldiri, APN-PMHNP
7765 Lake St Apt 2w,
River Forest, IL 60305-1732

Ph: (708) 955-6144
Mary Kotjabaldiri, APN-PMHNP
7765 Lake St Apt 2w,
River Forest, IL 60305-1732

Ph: (708) 955-6144

Reviews and Comments


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