Individual
TERESITA Q BANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
251 E HURON ST, FEINBERG 5-704, CHICAGO, IL 60611-2908
(312) 695-0061
(312) 695-9013
Mailing address
680 N LAKE SHORE DR, SUITE 1000, CHICAGO, IL 60611-4546
(312) 695-9797
(312) 695-6594
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2023044238
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
209008294
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072873
AANA
TX
05
—
174911105
—
TX
05
—
174911106
—
TX
01
—
85947U
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
01/23/2006
Last updated
11/04/2025
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