Basic Information
Provider Information
NPI: 1396828521
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HORWATH
FirstName: HARIKLIA
MiddleName: K
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2160 S FIRST AVE
Address2: 101 1740 LOYOLA UNIVERSITY MEDICAL CENTER
City: MAYWOOD
State: IL
PostalCode: 60153
CountryCode: US
TelephoneNumber: 7082169000
FaxNumber: 7082169033
Practice Location
Address1: 155 E BRUSH HILL RD
Address2:  
City: ELMHURST
State: IL
PostalCode: 601265658
CountryCode: US
TelephoneNumber: 3312211000
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/23/2006
LastUpdateDate: 04/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X209506857ILY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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