Healthcare Provider Details

I. General information

NPI: 1003876517
Provider Name (Legal Business Name): PERIOPERATIVE NURSING ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3315 ASPEN CT
JOLIET IL
60431-4903
US

IV. Provider business mailing address

3315 ASPEN CT
JOLIET IL
60431-4903
US

V. Phone/Fax

Practice location:
  • Phone: 815-741-0375
  • Fax: 815-741-9895
Mailing address:
  • Phone: 815-741-0375
  • Fax: 815-741-9895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number
License Number StateIL

VIII. Authorized Official

Name: DONNA A PULLMAN
Title or Position: PRESIDENT
Credential: CRNFA
Phone: 815-741-0375