Basic Information
Provider Information
NPI: 1639315922
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DNES
FirstName: OKSANA
MiddleName: SUZANNE
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: DNES
OtherFirstName: OKSANA
OtherMiddleName: SUZANNE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNA
OtherLastNameType: 2
Mailing Information
Address1: 4100 TRIUMVERA DR APT 103
Address2:  
City: GLENVIEW
State: IL
PostalCode: 600253852
CountryCode: US
TelephoneNumber: 8472178670
FaxNumber:  
Practice Location
Address1: 2650 RIDGE AVE
Address2:  
City: EVANSTON
State: IL
PostalCode: 602011718
CountryCode: US
TelephoneNumber: 8475702760
FaxNumber: 8475702921
Other Information
ProviderEnumerationDate: 12/17/2008
LastUpdateDate: 12/17/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X209.007363041.342266ILY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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