Healthcare Provider Details

I. General information

NPI: 1558884072
Provider Name (Legal Business Name): METRO OMAHA ANESTHESIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 S 24TH ST
OMAHA NE
68108-1825
US

IV. Provider business mailing address

21120 WASHINGTON PKWY
FRANKFORT IL
60423-3112
US

V. Phone/Fax

Practice location:
  • Phone: 847-691-9080
  • Fax:
Mailing address:
  • Phone: 815-469-9750
  • Fax: 815-469-9752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DANIEL BORVAN
Title or Position: PRESIDENT
Credential: CRNA
Phone: 815-370-1933