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General NPI Number Information
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NPI Number | 1427028679
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Entity Type | Individual
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Provider Name | TERESITA Q BANEZ CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 251 E HURON ST FEINBERG 5-704
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City | CHICAGO
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State | IL
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Zip | 60611-2908
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Country | US
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Telephone | 312-695-0061
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Fax | 312-695-9013
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Provider Business Mailing Address
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Address Line | 680 N LAKE SHORE DR SUITE 1000
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City | CHICAGO
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State | IL
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Zip | 60611-4546
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Country | US
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Telephone | 312-695-9797
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Fax | 312-695-6594
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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 | 209008294
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 2023044238
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License Number State | MO
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