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NPI Code Detail

MEDICARE: SUZANNE STEIN CRNA

MEDICARE: SUZANNE STEIN CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner209004671IL
2367500000XCertified Registered Nurse AnesthetistD177606IA
3367500000XCertified Registered Nurse Anesthetist28231827AIN
4367500000XCertified Registered Nurse Anesthetist209-006499IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
104532206OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1356340608
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE STEIN CRNA
Provider Business Mailing Address
First Line : 2202 HARLEM ROAD
Second Line :
City : LOVES PARK
State : IL
Zip : 61111-2754
Country : US
Telephone Number : 815-877-4848
Fax Number : 815-654-5342
Provider Business Practice Location Address
First Line : 2202 HARLEM ROAD
Second Line :
City : LOVES PARK
State : IL
Zip : 61111-2754
Country : US
Telephone Number : 815-877-4848
Fax Number : 815-654-5342
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 06/03/2025

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Directions to “ SUZANNE STEIN CRNA” Practice Location

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