Provider Demographics
NPI:1518135102
Name:KRYSCIO, RENEE JANUCHOWSKI (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:JANUCHOWSKI
Last Name:KRYSCIO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:SUSANNE
Other - Last Name:JANUCHOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:251 E HURON ST
Mailing Address - Street 2:OLSON PAVILION, SUITE 7428
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2908
Mailing Address - Country:US
Mailing Address - Phone:312-926-8369
Mailing Address - Fax:312-926-8341
Practice Address - Street 1:251 E HURON ST
Practice Address - Street 2:OLSON PAVILION, SUITE 7428
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:312-926-8369
Practice Address - Fax:312-926-8341
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209006978367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered