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Individual

ANGELA MARTIN BANKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, CRNA

Contact information

Practice address
12251 S 80TH AVE, PALOS HEIGHTS, IL 60463-1290
(708) 923-3936
(708) 923-8848
Mailing address
12251 S 80TH AVE, PALOS HEIGHTS, IL 60463-1290
(708) 923-3936
(708) 923-8848

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
204826
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
209025178
IL
367500000X
Certified Registered Nurse Anesthetist
3321632
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DH756
FL
01
G00CU
BC/BS
FL
Enumeration date
09/22/2005
Last updated
09/15/2022
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