Provider Demographics
NPI:1457686271
Name:WARREN, SHEILA (CRNA, RN)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:CRNA, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6345 S INGLESIDE AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-3619
Mailing Address - Country:US
Mailing Address - Phone:773-793-4152
Mailing Address - Fax:
Practice Address - Street 1:6345 S INGLESIDE AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-3619
Practice Address - Country:US
Practice Address - Phone:773-793-4152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041339952367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered