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NPI Code Detail

MEDICARE: MR. ALI SAID NOUWAIRI CRNA

MEDICARE: MR. ALI SAID NOUWAIRI 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 Nurse041.453369IL
2367500000XCertified Registered Nurse Anesthetist700015TX
3367500000XCertified Registered Nurse Anesthetist209.016095IL

General Provider Information

NPI Number : 1568424505
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALI SAID NOUWAIRI CRNA
Provider Business Mailing Address
First Line : 2202 HARLEM RD STE 200
Second Line :
City : LOVES PARK
State : IL
Zip : 61111-2754
Country : US
Telephone Number : 815-877-4848
Fax Number : 815-636-6125
Provider Business Practice Location Address
First Line : 2202 HARLEM RD STE 200
Second Line :
City : LOVES PARK
State : IL
Zip : 61111-2754
Country : US
Telephone Number : 815-877-4848
Fax Number : 815-636-6125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 03/19/2024

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