Individual
DR. ALEXANDRIA THIEL POULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CRNA,, BSN, RN,
Contact information
Practice address
2233 W DIVISION ST, CHICAGO, IL 60622-8151
(312) 770-2000
Mailing address
2233 W DIVISION ST, CHICAGO, IL 60622-8151
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
41423029
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209024184
IL
Other
Enumeration date
06/07/2021
Last updated
03/14/2023
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