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Individual

MS. GWENDOLYN BARR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1459 OLIVE RD, HOMEWOOD, IL 60430-2411
(708) 799-7476
(708) 799-0797
Mailing address
1459 OLIVE RD, HOMEWOOD, IL 60430-2411
(708) 799-7476
(708) 799-0797

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041178830
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
034107
RECERTIFICATION CARD
IL
01
041178830
IL STATE LICENSE
IL
Enumeration date
08/20/2006
Last updated
08/30/2010
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