1437542651 NPI number — MIDWEST ANESTHESIA AND PAIN SPECIALISTS, SC

Table of content: (NPI 1437542651)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437542651 NPI number — MIDWEST ANESTHESIA AND PAIN SPECIALISTS, SC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIDWEST ANESTHESIA AND PAIN SPECIALISTS, SC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437542651
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/06/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9680 GOLF ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DESPLAINES
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-362-2917
Provider Business Mailing Address Fax Number:
773-362-2768

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4354 W 63RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60629-5039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-362-2917
Provider Business Practice Location Address Fax Number:
773-362-2768
Provider Enumeration Date:
03/12/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SALDANHA
Authorized Official First Name:
DARREL
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
773-362-2917

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com