Healthcare Provider Details

I. General information

NPI: 1285220467
Provider Name (Legal Business Name): NABILA ELADLA APRN, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2020
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10400 HALIGUS RD FL 2
HUNTLEY IL
60142-9553
US

IV. Provider business mailing address

10400 HALIGUS RD FL 2
HUNTLEY IL
60142-9553
US

V. Phone/Fax

Practice location:
  • Phone: 224-654-0000
  • Fax:
Mailing address:
  • Phone: 224-654-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209.022522
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: