Individual
MS. JANICE WIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2000 OGDEN AVE, AURORA, IL 60504-7222
(630) 978-4860
Mailing address
185 PENNY AVE, EAST DUNDEE, IL 60118-1454
(847) 836-7015
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
041207241
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209001546
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374948725001
—
IL
Enumeration date
10/06/2006
Last updated
06/07/2023
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