Individual
MRS. MICHELLE ANN FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-8387
Mailing address
1244 BEVERLY DR, LAKE VILLA, IL 60046-6408
(847) 265-1654
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
IL
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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