Provenzano, John Marc

Provenzano, John Marc is an individual health care provider with primary practice located at 5841 S Maryland Ave , Chicago IL 60637-1447. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Provenzano, John Marc can be contacted via phone (773) 702-6700.

Contact Information

Primary practice address
5841 S Maryland Ave Chicago IL 60637-1447
Phone: (773) 702-6700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209001255 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 6183 North Carolina

Profile Details

NPI number 1437129335
LBN Legal business name Provenzano, John Marc
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2006
Last updated Feb 17th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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