Healthcare Provider Details

I. General information

NPI: 1184966236
Provider Name (Legal Business Name): EMILY CAYER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5145 N CALIFORNIA AVE
CHICAGO IL
60625-3661
US

IV. Provider business mailing address

205 W TOUHY AVE 151
PARK RIDGE IL
60068-4256
US

V. Phone/Fax

Practice location:
  • Phone: 773-878-8200
  • Fax: 773-293-8804
Mailing address:
  • Phone: 920-606-2653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number9188
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: