Individual
ELMA DIVINAGRACIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3249 OAK PARK AVE, ANESTHESIA DEPARTMENT, BERWYN, IL 60402-3429
(708) 783-3667
Mailing address
68 S. SERVICE RD, SUITE 350, MELVILLE, NY 11747-2358
(516) 945-3115
(516) 945-3131
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041167282
IL
Other
Enumeration date
06/30/2006
Last updated
10/13/2016
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