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General NPI Number Information
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NPI Number | 1659306272
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Entity Type | Organization
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Legal Business Name | AMBULATORY ANESTHESIOLOGISTS OF CHICAGO, LLC
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 60 E DELAWARE PL FL 15
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City | CHICAGO
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State | IL
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Zip | 60611-1998
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Country | US
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Telephone | 312-291-7432
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Fax | 877-235-5009
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Provider Business Mailing Address
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Address Line | PO BOX 88386
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City | CAROL STREAM
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State | IL
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Zip | 60188-8386
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Country | US
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Telephone | 312-291-7432
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Fax | 312-858-6104
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAY KIOKEMEISTER
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Credential | D.O.
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Telephone | 312-787-2998
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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 | IL
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