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NPI Code Detail

MEDICARE: RENIE ARIELLE TEAGUE CRNA

MEDICARE: RENIE ARIELLE TEAGUE 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
1367500000XCertified Registered Nurse Anesthetist209026126IL

General Provider Information

NPI Number : 1720703820
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENIE ARIELLE TEAGUE CRNA
Provider Business Mailing Address
First Line : 251 E HURON ST STE 5-704
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2908
Country : US
Telephone Number : 312-926-8369
Fax Number : 312-926-8341
Provider Business Practice Location Address
First Line : 251 E HURON ST STE 5-704
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2908
Country : US
Telephone Number : 312-926-8369
Fax Number : 312-926-8341
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2022
Last Update Date : 05/26/2026

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Directions to “ RENIE ARIELLE TEAGUE CRNA” Practice Location

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