Individual
MS. AMANDA M DECIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1301 W 22ND ST, #610, OAK BROOK, IL 60523-2006
(630) 537-1720
Mailing address
1301 W 22ND ST, #610, OAK BROOK, IL 60523-2006
(630) 537-1720
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209.007301
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308217200
—
FL
01
—
G4231
BCBSFL
—
Enumeration date
03/09/2007
Last updated
01/06/2015
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