Healthcare Provider Details

I. General information

NPI: 1326159070
Provider Name (Legal Business Name): UNITED ANESTHESIA ASSOCIATES SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 10/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

934 CENTER ST
ELGIN IL
60120-2125
US

IV. Provider business mailing address

5452 RELIABLE PARKWAY
CHICAGO IL
60686-0001
US

V. Phone/Fax

Practice location:
  • Phone: 847-429-2932
  • Fax: 847-429-2032
Mailing address:
  • Phone: 847-429-2932
  • Fax: 847-429-2032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: ANDREW WARD
Title or Position: PRESIDENT
Credential: MD
Phone: 847-429-2932