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Individual

ASHLEY HALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2202 HARLEM RD, LOVES PARK, IL 61111-2754
(815) 877-4848
(815) 654-5342
Mailing address
2202 HARLEM RD, LOVES PARK, IL 61111-2754
(815) 877-4848
(815) 636-6125

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.319893
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209.011836
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P01448014
RAILROAD MEDICARE
IL
Enumeration date
09/15/2014
Last updated
03/30/2017
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