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General NPI Number Information
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NPI Number | 1609434216
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Entity Type | Organization
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Legal Business Name | MIDWEST ANESTHESIA AND PAIN SPECIALISTS, SC
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Dates
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Enumeration Date | 05/30/2019
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Last Update Date | 05/30/2019
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Provider Practice Location Address
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Address Line | 2923 N CALIFORNIA AVE STE 210
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City | CHICAGO
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State | IL
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Zip | 60618-7702
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Country | US
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Telephone | 847-348-8250
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Fax |
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Provider Business Mailing Address
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Address Line | 9680 GOLF RD
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City | DES PLAINES
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State | IL
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Zip | 60016-1522
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | GABRIELA MALDONADO
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Credential |
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Telephone | 773-362-2917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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