MEDICARE: ANN B MUNOZ 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
1	367500000X	Certified Registered Nurse Anesthetist	209005135	IL

General Provider Information

NPI Number	:	1417959990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN B MUNOZ CRNA

Provider Business Mailing Address
First Line	:	680 N LAKE SHORE DR STE 1000
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-8709
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	251 E HURON ST
Second Line	:	FEINBERG 5-704
City	:	CHICAGO
State	:	IL
Zip	:	60611-2908
Country	:	US
Telephone Number	:	312-695-0061
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	04/26/2016

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Directions to “ ANN B MUNOZ CRNA” Practice Location

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