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NPI Code Detail

MEDICARE: JOAN YOUNG CRNA

MEDICARE: JOAN YOUNG 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
1367500000XCertified Registered Nurse Anesthetist041260586IL

General Provider Information

NPI Number : 1518925544
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN YOUNG CRNA
Provider Business Mailing Address
First Line : 77 N AIRLITE ST
Second Line :
City : ELGIN
State : IL
Zip : 60123-4912
Country : US
Telephone Number : 847-695-3200
Fax Number :
Provider Business Practice Location Address
First Line : 77 N AIRLITE ST
Second Line :
City : ELGIN
State : IL
Zip : 60123-4912
Country : US
Telephone Number : 847-695-3200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 11/25/2013

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