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Individual

AMY BLANKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
13959 95TH AVENUE, ORLAND PARK, IL 60462
(843) 615-3535
Mailing address
13959 S 95TH AVE, ORLAND PARK, IL 60462-1204
(843) 615-3535

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209014650
IL

Other

Enumeration date
08/31/2016
Last updated
08/31/2016
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