Individual
AMY M BOETTCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5645 W ADDISON ST, CHICAGO, IL 60634-4403
(773) 282-7000
Mailing address
PO BOX 836, CRYSTAL LAKE, IL 60039-0836
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
041377585
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA250537
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041377585
LICENSE
IL
Enumeration date
01/22/2018
Last updated
10/04/2021
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