Provider Demographics
NPI:1861030215
Name:BOUTON SANCHEZ, AMBER MARIE (DNP, CRNA)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:MARIE
Last Name:BOUTON SANCHEZ
Suffix:
Gender:
Credentials:DNP, CRNA
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:MARIE
Other - Last Name:BOUTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, CRNA
Mailing Address - Street 1:2160 S 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:708-216-9000
Mailing Address - Fax:
Practice Address - Street 1:2160 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-216-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-43-2406367500000X
IL209020794367500000X
IL209.020794207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041432406OtherILLINOIS REGISTERED NURSE LICENSE