MEDICARE: EUGENE VAYMAN 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
1	367500000X	Certified Registered Nurse Anesthetist	209006528	IL

General Provider Information

NPI Number	:	1306802442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUGENE VAYMAN CRNA

Provider Business Mailing Address
First Line	:	2111 S ARLINGTON HEIGHTS RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-4105
Country	:	US
Telephone Number	:	314-706-2715
Fax Number	:

Provider Business Practice Location Address
First Line	:	2111 S ARLINGTON HEIGHTS RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-4105
Country	:	US
Telephone Number	:	314-706-2715
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	10/12/2012

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