Individual
SERGEY REVEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
611 W. PARK ST., ANESTHESIOLOGY, URBANA, IL 61801-2500
(217) 383-3303
(217) 383-3265
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
ARNP9296749
FL
367H00000X
Anesthesiologist Assistant
Primary
2090121874
IL
Other
Enumeration date
07/21/2014
Last updated
01/08/2015
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