Healthcare Provider Details

I. General information

NPI: 1497668537
Provider Name (Legal Business Name): CLARION ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17505 N 79TH AVE STE 304E
GLENDALE AZ
85308-8729
US

IV. Provider business mailing address

17505 N 79TH AVE STE 304E
GLENDALE AZ
85308-8729
US

V. Phone/Fax

Practice location:
  • Phone: 773-844-8663
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MATTHEW CROOKS
Title or Position: OWNER
Credential: MD
Phone: 773-844-8663