Individual
CHRIS LATHITHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2160 S 1ST AVE, BLDG 103, RM-3102, MAYWOOD, IL 60153-3328
(708) 216-6462
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209013876
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041374207
STATE RN LICENSE NUMBER
IL
Enumeration date
02/17/2016
Last updated
02/05/2025
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