Healthcare Provider Details

I. General information

NPI: 1194306563
Provider Name (Legal Business Name): ASHLEY JILLANE READ CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY JILLANE SMALL RN, SRNA

II. Dates (important events)

Enumeration Date: 04/17/2021
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 E WATERSIDE DR UNIT 2001
CHICAGO IL
60601-4722
US

IV. Provider business mailing address

1605 E CENTRAL RD UNIT 121C
ARLINGTON HEIGHTS IL
60005-3339
US

V. Phone/Fax

Practice location:
  • Phone: 509-344-9807
  • Fax:
Mailing address:
  • Phone: 509-344-9807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number041482878
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP61300972
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209.023391
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: