Basic Information
| Provider Information | |||||||||
| NPI: | 1265860662 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THUESON | ||||||||
| FirstName: | ERIC | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 E LE FEVRE RD | ||||||||
| Address2: | |||||||||
| City: | STERLING | ||||||||
| State: | IL | ||||||||
| PostalCode: | 610811278 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8155644407 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 E LEFEVRE RD | ||||||||
| Address2: | |||||||||
| City: | STERLING | ||||||||
| State: | IL | ||||||||
| PostalCode: | 610811279 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8156250400 | ||||||||
| FaxNumber: | 8156252747 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2013 | ||||||||
| LastUpdateDate: | 03/09/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 209010811 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.