| NPI | 1346353661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK M EATON President 618-241-1108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 42617784) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 42617784) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 42617784) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |