| NPI | 1063955078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL WITHERS Dir Of Credentialing & Enrollment 312-227-6415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207LC0200X Anesthesiology, Critical Care Medicine | |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2022-08-24 |