1922410729 NPI number — MRS. SHARON ESTELLE-WARNER PHILIPS CRNA

Table of content: MRS. SHARON ESTELLE-WARNER PHILIPS CRNA (NPI 1922410729)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922410729 NPI number — MRS. SHARON ESTELLE-WARNER PHILIPS CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PHILIPS
Provider First Name:
SHARON
Provider Middle Name:
ESTELLE-WARNER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WARNER
Provider Other First Name:
SHARON
Provider Other Middle Name:
ESTELLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1922410729
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/21/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1537 N VEST DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NAPERVILLE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60563-9381
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-709-7990
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 BIESTERFIELD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELK GROVE VLG
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60007-3361
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-437-5500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/28/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  RN609466 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: 95000154 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: 209014674 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)