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General NPI Number Information
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NPI Number | 1124058359
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Entity Type | Individual
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Provider Name | PHYLLIS MARIE SIT APN, CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 03/06/2013
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Provider Practice Location Address
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Address Line | 1901 W HARRISON ST ROOM 3675
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City | CHICAGO
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State | IL
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Zip | 60612-3714
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Country | US
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Telephone | 312-864-3215
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Fax | 312-864-9600
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Provider Business Mailing Address
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Address Line | 120 BARRYPOINT RD
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City | RIVERSIDE
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State | IL
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Zip | 60546-2840
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Country | US
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Telephone | 708-447-7440
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Fax | 312-864-9600
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 209000411
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License Number State | IL
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