Provider Demographics
NPI:1477146819
Name:RIESMEYER, MARY FRANCES (APN-CRNA)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:FRANCES
Last Name:RIESMEYER
Suffix:
Gender:
Credentials:APN-CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 GROSS POINT RD
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1214
Mailing Address - Country:US
Mailing Address - Phone:847-933-6909
Mailing Address - Fax:847-933-3829
Practice Address - Street 1:9600 GROSS POINT RD
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1214
Practice Address - Country:US
Practice Address - Phone:847-933-6909
Practice Address - Fax:847-933-3829
Is Sole Proprietor?:No
Enumeration Date:2021-02-17
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS43-558205-091367500000X
MO2024004786367500000X
IL209022873367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered