1477525483 NPI number — HARVEY ANESTHESIOLOGISTS SC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477525483 NPI number — HARVEY ANESTHESIOLOGISTS SC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARVEY ANESTHESIOLOGISTS 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:
1477525483
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
222 E DUNDEE RD
Provider Second Line Business Mailing Address:
HARVEY ANESTHESIOLOGISTS SC
Provider Business Mailing Address City Name:
WHEELING
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60090
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-520-0235
Provider Business Mailing Address Fax Number:
847-520-0390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 INGALLS DR
Provider Second Line Business Practice Location Address:
INGALLS MEMORIAL HOSPITAL
Provider Business Practice Location Address City Name:
HARVEY
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60426-3558
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-333-2300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
AGARWAL
Authorized Official First Name:
SURESH
Authorized Official Middle Name:
P
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
773-333-2300

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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