Healthcare Provider Details

I. General information

NPI: 1942510151
Provider Name (Legal Business Name): DANIELLE M NAKHSHIN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2010
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 N AIRLITE ST
ELGIN IL
60123-4912
US

IV. Provider business mailing address

1608 SYCAMORE PL
SCHAUMBURG IL
60173-4110
US

V. Phone/Fax

Practice location:
  • Phone: 619-807-2052
  • Fax:
Mailing address:
  • Phone: 619-807-2052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209-009148
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: