Individual
STANI KURIAKOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2000
Mailing address
998 CHURCH ST UNIT 429, GLENVIEW, IL 60025-3093
(469) 855-4543
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.519832
IL
163W00000X
Registered Nurse
209.024923
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209024923
IL
Other
Enumeration date
03/18/2022
Last updated
10/01/2024
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