Healthcare Provider Details

I. General information

NPI: 1174508980
Provider Name (Legal Business Name): SLEEPERS ANESTHESIA SERVICE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 12/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 FRONT ST
GALVA IL
61434-1365
US

IV. Provider business mailing address

39 EDGEWOOD DR
KEWANEE IL
61443-3108
US

V. Phone/Fax

Practice location:
  • Phone: 309-854-7246
  • Fax: 309-853-9605
Mailing address:
  • Phone: 309-854-7246
  • Fax: 309-853-9605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM K BARNHILL
Title or Position: OWNER
Credential: CRNA
Phone: 309-854-7246