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Individual

JANESSA TERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN-CRNA

Contact information

Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2760
Mailing address
2650 RIDGE AVE STE 1223, EVANSTON, IL 60201-1700
(847) 570-2760

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209027641
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041496306
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
08/26/2021
Last updated
08/01/2023
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