Individual
ALICE ELENA TUDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3134 N CLARK ST, CHICAGO, IL 60657-4414
(773) 766-4949
(312) 766-4909
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
(847) 390-4757
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
209.010958
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
RN195845
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003145166A
—
GA
Enumeration date
11/19/2013
Last updated
01/10/2022
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