Individual
ANOOP BANATHIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2912 MARION AVE, MELROSE PARK, IL 60164-1002
(847) 260-5115
Mailing address
2912 MARION AVE, MELROSE PARK, IL 60164-1002
(847) 260-5115
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.382319
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209015301
IL
Other
Enumeration date
09/18/2016
Last updated
02/16/2017
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