Healthcare Provider Details

I. General information

NPI: 1427069772
Provider Name (Legal Business Name): ANNE T. HINKAMP CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 10/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 N LAKE SHORE DR
CHICAGO IL
60657-5640
US

IV. Provider business mailing address

401 E ONTARIO ST APT 2201
CHICAGO IL
60611-7178
US

V. Phone/Fax

Practice location:
  • Phone: 773-665-3000
  • Fax:
Mailing address:
  • Phone: 312-640-1105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number041211445
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: