MEDICARE: MRS. ROXANNE FITZGERALD 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	209.008482	IL

General Provider Information

NPI Number	:	1972805851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROXANNE FITZGERALD CRNA

Provider Business Mailing Address
First Line	:	7720 W CLARENCE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-1832
Country	:	US
Telephone Number	:	773-775-7730
Fax Number	:

Provider Business Practice Location Address
First Line	:	7720 W CLARENCE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-1832
Country	:	US
Telephone Number	:	773-775-7730
Fax Number	:

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

Provider Enumeration Date	:	11/26/2010
Last Update Date	:	04/15/2025

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