Healthcare Provider Details

I. General information

NPI: 1962753004
Provider Name (Legal Business Name): ANDREA ALVEREZ DORSEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2012
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N WINFIELD RD
WINFIELD IL
60190-1379
US

IV. Provider business mailing address

25 N WINFIELD RD
WINFIELD IL
60190-1379
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-6675
  • Fax: 630-933-2614
Mailing address:
  • Phone: 630-933-6675
  • Fax: 630-933-2614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4035262
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP06934
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2022009225
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209028611
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: