Individual
JENNIFER VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2540 HANFORD LN, AURORA, IL 60502-6969
(815) 748-8993
Mailing address
116 PRESIDENTIAL BLVD, OSWEGO, IL 60543-9816
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209007942
IL
Other
Enumeration date
01/02/2010
Last updated
01/02/2010
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