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NPI Code Detail

MEDICARE: MRS. SONA YOGESH AQUILINE CRNA

MEDICARE:  MRS. SONA YOGESH AQUILINE  CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse041354663IL
2367500000XCertified Registered Nurse Anesthetist209.009186IL

General Provider Information

NPI Number : 1285917641
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SONA YOGESH AQUILINE CRNA
Provider Business Mailing Address
First Line : 1459 W CARMEN AVE
Second Line : GARDEN APT.
City : CHICAGO
State : IL
Zip : 60640-7557
Country : US
Telephone Number : 773-561-3233
Fax Number :
Provider Business Practice Location Address
First Line : 500 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4906
Country : US
Telephone Number : 630-312-6677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2011
Last Update Date : 07/27/2015

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