Provider Demographics
NPI:1164439089
Name:WINTERMAN, MARIA (CRNA)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:WINTERMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 W TERRA COTTA PL APT A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1992
Mailing Address - Country:US
Mailing Address - Phone:773-525-3797
Mailing Address - Fax:
Practice Address - Street 1:1728 W TERRA COTTA PL APT A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1992
Practice Address - Country:US
Practice Address - Phone:773-525-3797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK20687Medicare ID - Type Unspecified
ILK21433Medicare ID - Type Unspecified
ILK21432Medicare ID - Type Unspecified