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Individual

MR. BENJAMIN SALAZAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
3249 OAK PARK AVE, BERWYN, IL 60402-0715
(708) 783-9100
Mailing address
3811 W 51ST ST, CHICAGO, IL 60632-3613
(312) 480-5273

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.422347
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
041.422347
IL

Other

Enumeration date
01/16/2019
Last updated
06/04/2019
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