Healthcare Provider Details

I. General information

NPI: 1295015154
Provider Name (Legal Business Name): HFMC ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2011
Last Update Date: 08/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N RIVER RD
DES PLAINES IL
60016-1209
US

IV. Provider business mailing address

925 SHERWOOD DR
LAKE BLUFF IL
60044-2203
US

V. Phone/Fax

Practice location:
  • Phone: 847-297-1800
  • Fax:
Mailing address:
  • Phone: 847-615-2200
  • Fax: 888-735-8732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DONALD HARKESS
Title or Position: CFO
Credential: CFO
Phone: 847-433-1539