| Doctor Name: | DOLORES THEISS |
| NPI Number: | 1003995259 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNFA |
| License Number: | |
| Business Practice Address: | 2350 Royal Blvd Suite 200 Elgin, IL - 601234719 |
| Business Phone Number: | 8479315300 |
| Business Fax Number: | 8479319072 |
| Mailing Address: | 2350 Royal Blvd, Suite 200 ELGIN |
| State: | IL |
| Postal Code: | 601234719 |
| Phone Number: | 8479315300 |
| Fax Number: | 8479319072 |
| NPI Enumeration Date: | 11/06/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SM0705X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Medical-Surgical |
| Taxonomy Definition: | |