Individual
NICHOLAS K VENTOCILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
875 S ROUTE 31, CRYSTAL LAKE, IL 60014-8190
(779) 220-5500
Mailing address
PO BOX 836, CRYSTAL LAKE, IL 60039-0836
(847) 615-2200
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209014237
IL
Other
Enumeration date
04/18/2016
Last updated
10/02/2023
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