Healthcare Provider Details

I. General information

NPI: 1225094717
Provider Name (Legal Business Name): HOLLY L. LEISCHNER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 E BRUSH HILL RD
ELMHURST IL
60126-5658
US

IV. Provider business mailing address

386 N LARCH AVE
ELMHURST IL
60126-2314
US

V. Phone/Fax

Practice location:
  • Phone: 331-221-1000
  • Fax:
Mailing address:
  • Phone: 773-551-3724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209005879
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: