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General NPI Number Information
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NPI Number | 1588986046
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Entity Type | Organization
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Legal Business Name | WINDY CITY ANESTHESIA, PC
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Dates
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Enumeration Date | 02/24/2010
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Last Update Date | 04/30/2015
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Provider Practice Location Address
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Address Line | 47601 GRAND RIVER AVE
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City | NOVI
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State | MI
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Zip | 48374-1233
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Country | US
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Telephone | 815-462-8470
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Fax |
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Provider Business Mailing Address
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Address Line | 21120 WASHINGTON PKWY
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City | FRANKFORT
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State | IL
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Zip | 60423-3112
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Country | US
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Telephone | 815-462-8470
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Fax | 815-462-8471
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL BORVAN
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Credential | CRNA
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Telephone | 815-462-8470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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