Healthcare Provider Details
I. General information
NPI: 1740074525
Provider Name (Legal Business Name): MIDWEST ANESTHESIA AND PAIN SPECIALISTS SC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/07/2025
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10095 W LINCOLN HWY
FRANKFORT IL
60423-1272
US
IV. Provider business mailing address
9680 GOLF RD
DES PLAINES IL
60016-1522
US
V. Phone/Fax
- Phone: 815-806-0400
- Fax: 815-806-0406
- Phone: 773-362-2917
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DARREL
J
SALDANHA
Title or Position: CEO
Credential: MD
Phone: 773-362-2917